NPIMap

Organization Active NPI

Mooresville Pharmacy East LLC

  • Pharmacist
  • Mooresville, NC
National Provider Identifier
1043345135
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
08134 Issued in NC
Legal business name
MOORESVILLE PHARMACY EAST LLC
Practice address
439 E Statesville Ave
Suite a
Mooresville, NC 28115-2533
Phone
(877) 454-0448
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gavin M Houchins, PHARM.D.
Title
Owner
Phone
(704) 799-6870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 08134 NC Primary

Addresses

Primary practice location

439 E Statesville Ave
Suite a
Mooresville, NC 28115-2533

Mailing address

439 E Statesville Ave
Suite a
Mooresville, NC 28115-2533
Phone (877) 454-0448

Other identifiers 1

IdentifierTypeStateIssuer
3440093OtherNCNABP

Other names 1

  • Mooresville Compounding Specialties Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healthsmart Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

439 E Statesville Ave
Ste A
Mooresville, NC 28115
Phone (877) 454-0448

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043345135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 E STATESVILLE AVE",
            "address_2": "SUITE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152533",
            "telephone_number": "877-454-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 E STATESVILLE AVE",
            "address_2": "SUITE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152533",
            "telephone_number": "877-454-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE PHARMACY EAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOUCHINS",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-799-6870",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "08134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3440093",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mooresville Compounding Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.