| NPI | 1124060942 |
|---|---|
| Doing Business As | MOOSE COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JOSEPH MOOSE Owner 704-792-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NC 09216) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| 333600000X Pharmacy | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2010-12-30 |