NPIMap

Organization Active NPI

Moose Drug Company

  • Community/Retail Pharmacy
  • Concord, NC
National Provider Identifier
1124060942
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
09216 Issued in NC
Legal business name
MOOSE DRUG COMPANY
Practice address
740 Church St N
Concord, NC 28025-4336
Phone
(704) 792-2555
Fax
(704) 789-9366
NPI assigned
Jun 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Joseph Moose, PHARMD
Title
Owner
Phone
(704) 792-2555

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 09216 NC Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

740 Church St N
Concord, NC 28025-4336

Mailing address

740 Church St N
Concord, NC 28025-4336
Phone (704) 792-2555

Other identifiers 1

IdentifierTypeStateIssuer
3405049OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MOOSE COMPOUNDING PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Moose Drug Co7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

740 Church St N
Concord, NC 28025
Phone (704) 784-9613

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1124060942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254336",
            "telephone_number": "704-792-2555",
            "fax_number": "704-789-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254336",
            "telephone_number": "704-792-2555",
            "fax_number": "704-789-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOOSE DRUG COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "MOOSE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-792-2555",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "09216",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3405049",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOOSE COMPOUNDING PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.