Stanley Specialty Pharmacy, LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

STANLEY SPECIALTY PHARMACY, LLC

Doing business as

Stanley Specialty Pharmacy

Practice address

3120 Latrobe Dr Ste 200
Charlotte, NC 28211-2185

Phone

(704) 370-6612

Fax

(704) 375-5888

NPI assigned

Feb 24, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Brett Cannon, PHARMD

Title

Pic / Owner

Phone

(704) 370-6612

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stanley Specialty Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1972202315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 LATROBE DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112185",
            "telephone_number": "704-370-6612",
            "fax_number": "704-375-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 LATROBE DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112185",
            "telephone_number": "704-370-6612",
            "fax_number": "704-375-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY SPECIALTY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PIC / OWNER",
        "authorized_official_telephone_number": "704-370-6612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "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": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE PHARMACY LICENSE",
            "identifier": "24598",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanley Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Elizabeth Stanford Picker, MSW, LCSW
• Ala Stanford
• Megan Ann Stangeby
• Marko Stankovic, PHARMD
• Laurel Stanley Glynn
• Amanda A Stanley
• Courtney M Stanley, M.S. OTR/L
• Gregory Alan Stanley, MD
• Katlyn Marie Stanley, FNP
• Marselene Stanley, LCSW

• Compounding Pharmacy in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Compounding Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.