| NPI | 1164875340 |
|---|---|
| Doing Business As | CANNON PHARMACY MOORESVILLE DME |
| Entity Type | Organization |
| Authorized Contact | RYAN YANICKO Pharmacist Owner 704-658-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NC 1225412562) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2022-11-02 |