NPIMap

Organization Active NPI

Mooresville Compounding Specialties Pharmacy

  • Compounding Pharmacy
  • Mooresville, NC
National Provider Identifier
1053553891
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
08134 Issued in NC
Legal business name
MOORESVILLE COMPOUNDING SPECIALTIES PHARMACY
Practice address
594 N Main St BLDG B
Mooresville, NC 28115-2328
Phone
(704) 799-3299
NPI assigned
Mar 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Authorized official

Name
Gavin Houchins, PHARM.D,
Title
Pharmacist/Owner
Phone
(704) 799-3299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 08134 NC Primary

Addresses

Primary practice location

594 N Main St BLDG B
Mooresville, NC 28115-2328

Mailing address

594 N Main St BLDG B
Mooresville, NC 28115-2328

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

594 N Main St
Bldg B
Mooresville, NC 28115
Phone (704) 799-3299

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1053553891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 N MAIN ST BLDG B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 N MAIN ST BLDG B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152328",
            "telephone_number": "704-799-3299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE COMPOUNDING SPECIALTIES PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "HOUCHINS",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "704-799-3299",
        "authorized_official_credential": "PHARM.D,"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NC",
            "license": "08134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 9, 2014; 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.