Organization Active NPI

Moose Pharmacy of Monroe

  • Pharmacy
  • Monroe, NC
National Provider Identifier
1497386403
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
MOOSE PHARMACY OF MONROE
Practice address
215 E Jefferson St
Monroe, NC 28112-4865
Phone
(704) 283-8131
Fax
(704) 289-1954
NPI assigned
Jan 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Ashley Lynn Moose, PHARMDNPI 1780820605
Title
Manager/Owner
Phone
(704) 283-8131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

215 E Jefferson St
Monroe, NC 28112-4865

Mailing address

215 E Jefferson St
Monroe, NC 28112-4865
Phone (704) 283-8131

Other identifiers 1

IdentifierTypeStateIssuer
14278OtherNCNORTH CAROLINA BOARD OF PHARMACY LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200924002596 NC Part B Supplier - Mass Immunization (Roster Biller Only) 2466871405 Practice locations: Monroe, NC
O20201222002377 NC DME Supplier - Pharmacy 2466871405 Practice locations: Monroe, NC

National Provider Directory

National Provider Directory
Tax ID family
Moose Pharmacy of Monroe LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1497386403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E JEFFERSON ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124865",
            "telephone_number": "704-283-8131",
            "fax_number": "704-289-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E JEFFERSON ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124865",
            "telephone_number": "704-283-8131",
            "fax_number": "704-289-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOOSE PHARMACY OF MONROE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "MOOSE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "704-283-8131",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF PHARMACY LICENSE NUMBER",
            "identifier": "14278",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.