| Organization Name: | MOORESVILLE COMPOUNDING SPECIALTIES PHARMACY |
| NPI Number: | 1053553891 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GAVIN HOUCHINS (PHARMACIST/OWNER) |
| Mailing Address: | 594 N Main St Bldg B Mooresville |
| State: | NC US |
| Postal Code: | 281152328 |
| Phone Number: | 7047993299 |
| Fax Number: | |
| NPI Enumeration Date: | 03/25/2009 |
| NPI Last Update Date: | 07/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | 08134 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |