Cannon Pharmacy Salisbury, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CANNON PHARMACY SALISBURY, LLC

Practice address

1401 S. Jake Alexander Blvd
Salisbury, NC 28146-8359

Phone

(980) 892-0700

Fax

(980) 892-0750

NPI assigned

Dec 21, 2018

Organization subpart

Yes

Parent organization

CANNON HEALTH, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Christopher K. HanNPI 1366736910

Title

Managing Member

Phone

(980) 892-0700

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Cannon Pharmacy Enhanced Care 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.

• Cannon Pharmacy Salisbury, LLC

  • Long Term Care Pharmacy
  • Salisbury, NC
  • NPI 1083135685
  NPD tax ID

Locations

Practitioners 2

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

• Christopher Kwang Han, PHARM.D.

  • Pharmacist
  • Charlotte, NC
  • NPI 1366736910
  NPD Authorized official
• Ryan Thomas Yanicko, PHARM.D.

  • Pharmacist
  • Mooresville, NC
  • NPI 1740565076
  NPD

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597017600000",
    "number": "1811469372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CABARRUS AVE W STE 23",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255150",
            "telephone_number": "704-886-0840",
            "fax_number": "704-933-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S. JAKE ALEXANDER BLVD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281468359",
            "telephone_number": "980-892-0700",
            "fax_number": "980-892-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANNON PHARMACY SALISBURY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CANNON HEALTH, LLC",
        "enumeration_date": "2018-12-21",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "HAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "980-892-0700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennesha D Campbell, OT
• Morgan Wright Campbell, PA
• Sabrina Michelle Campbell, PMHNP-BC
• Saprina Campbell, LPN
• Cannon Pharmacy Salisbury, LLC
• Connie Somido Capinpin, OTR/L
• Kenneth Ralph Capone, RPH
• Christopher Joseph Cappello, MD
• Care Medical Supply, Inc
• Care Transport Group, Inc

• Community/Retail Pharmacy in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.