Healthcare Provider Details

I. General information

NPI: 1790657609
Provider Name (Legal Business Name): EMORY ASHTON MOSS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 PINEVILLE MATTHEWS RD STE 102
CHARLOTTE NC
28226-8380
US

IV. Provider business mailing address

7108 PINEVILLE MATTHEWS RD STE 102
CHARLOTTE NC
28226-8380
US

V. Phone/Fax

Practice location:
  • Phone: 704-542-2191
  • Fax: 704-542-4243
Mailing address:
  • Phone: 704-542-2191
  • Fax: 704-542-4243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34137
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number34137
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: