Moose Pharmacy of Mt Holly LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MOOSE PHARMACY OF MT HOLLY LLC

Doing business as

Moose Pharmacy of Mount Holly Long-Term Care

Practice address

125 W Central Ave
Mount Holly, NC 28120-1616

Phone

(704) 827-2211

Fax

(704) 827-7134

NPI assigned

May 8, 2023

Organization subpart

No

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

Authorized official

Name

Brandi M Grist, PHARMD

Title

Pharmacy Owner/Manager

Phone

(704) 827-2211

Specialties & licenses 1

Addresses

Other names 1

• Moose Pharmacy of Mount Holly Long-Term Care Doing business as

Tax ID family

Moose Pharmacy of Mount Holly Long-Term Care2 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.

• Moose Pharmacy of Mt Holly LLC

  • Community/Retail Pharmacy
  • Mount Holly, NC
  • NPI 1437648334
  NPD tax ID

Locations

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1720778442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W CENTRAL AVE",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281201616",
            "telephone_number": "704-827-2211",
            "fax_number": "704-827-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W CENTRAL AVE",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281201616",
            "telephone_number": "704-827-2211",
            "fax_number": "704-827-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOOSE PHARMACY OF MT HOLLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "GRIST",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACY OWNER/MANAGER",
        "authorized_official_telephone_number": "704-827-2211",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moose Pharmacy of Mount Holly Long-Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Rae-Tsukamoto McGahan, DO
• Sydney McGee
• MF Express Lab and Vitality Center
• Michael D Emmett
• Moose Pharmacy of Mt Holly LLC
• Nicole Kristine Morton, LCMHCA
• Mount Holly Dentistry
• Mount Holly Eye Clinic, OD, PA
• Mountain Island Charter School Inc
• Moving Forward Express Health and Home Care Services

• Long Term Care Pharmacy in Mount Holly, NC
• Providers in Mount Holly, NC by specialty
• Long Term Care Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.