Cannon Pharmacy Mooresville

LBN: Panther Health Llc
Cannon Pharmacy Mooresville is an health care organization with primary practice located at 521 E Plaza Dr , Mooresville NC 28115-8071. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Panther Health Llc can be contacted via phone (704) 658-9870, or through Yanicko, Ryan via phone (704) 658-9870.

Contact Information

Primary practice address
521 E Plaza Dr Mooresville NC 28115-8071
Phone: (704) 658-9870
Fax: (704) 658-9871
Website:
Map and Directions
Authorized official contact:
Name: Yanicko, Ryan PHARMD
Phone: (704) 658-9870

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 12647 North Carolina

Profile Details

NPI number 1225412562
LBN Legal business name Panther Health Llc
DBA Doing business as Cannon Pharmacy Mooresville
Authorized official Yanicko, Ryan PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2015
Last updated Nov 2nd, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225412562 NPPES
Other 2153237 PK
MEDICAID 1225412562 PK

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