NPIMap

Organization Active NPI

Moose Pharmacy of Kannapolis, Inc

  • Long Term Care Pharmacy
  • Kannapolis, NC
National Provider Identifier
1982976288
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MOOSE PHARMACY OF KANNAPOLIS, INC
Practice address
1113 N Main St
Kannapolis, NC 28081-2256
Phone
(704) 932-9111
Fax
(704) 932-0197
NPI assigned
Feb 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Kyle Yoder
Title
Treasurer
Phone
(704) 636-6340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

1113 N Main St
Kannapolis, NC 28081-2256

Mailing address

1113 N Main St
Kannapolis, NC 28081-2256
Phone (704) 932-9111

Other identifiers 2

IdentifierTypeStateIssuer
3407916OtherNCNABP
0805839MedicaidNC

Other names 1

  • Moose Pharmacy of Kannapolis Long-Term Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Moose Pharmacy of Kannapolis2 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 4

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": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1982976288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 N MAIN ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280812256",
            "telephone_number": "704-932-9111",
            "fax_number": "704-932-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1113 N MAIN ST",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280812256",
            "telephone_number": "704-932-9111",
            "fax_number": "704-932-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOOSE PHARMACY OF KANNAPOLIS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "YODER",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "704-636-6340"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3407916",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0805839",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moose Pharmacy of Kannapolis Long-Term Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kannapolis, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.