| NPI | 1245920156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WHITAKER MOOSE Pharmacy Owner 704-436-9613 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2025-04-11 |