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General NPI Number Information
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NPI Number | 1598135568
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Entity Type | Organization
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Legal Business Name | CANNON DRUG CO
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 342 E PARKER RD
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City | MORGANTON
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State | NC
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Zip | 28655-5111
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Country | US
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Telephone | 828-433-5120
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Fax | 828-433-5149
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Provider Business Mailing Address
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Address Line | 342 E PARKER RD
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City | MORGANTON
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State | NC
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Zip | 28655-5111
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Country | US
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Telephone | 828-433-5120
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Fax | 828-433-5149
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Authorized Official
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Title or Position | PHARMACIST, PRESIDENT
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Name | MR. WILLIAM BRUCE CANNON
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Credential | RPH
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Telephone | 828-433-5120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 04574
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License Number State | NC
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