{"npi":"1669626164","type":"NPI-2","status":"active","name":{"display":"Moose Pharmacy Of Salisbury LLC","other":[],"organization_name":"MOOSE PHARMACY OF SALISBURY LLC","authorised_official":"Kyle Yoder"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"3336C0004X","description":"Compounding Pharmacy","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"NC","license":"10174"}]},"addresses":[{"purpose":"LOCATION","street_1":"1408 W INNES ST","city":"SALISBURY","state":"NC","postal_code":"281442502","country_code":"US","phone":"7046366340","fax":"7046470917"},{"purpose":"MAILING","street_1":"1408 W INNES ST","city":"SALISBURY","state":"NC","postal_code":"281442502","country_code":"US","phone":"7046366340","fax":"7046366340"}],"license":{"state":"NC","number":"10174"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"7701294","state":"NC","issuer":null},{"type_code":"01","label":"Other","value":"3412587","state":null,"issuer":"NCPDP PROVIDER IDENTIFICATION NUMBER"},{"type_code":"05","label":"Medicaid","value":"080-5530","state":"NC","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930024751","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"NC","pac_id":"0244396265"},{"enrlmt_id":"O20140610001589","type_code":"12-73","type_desc":"PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)","state":"NC","pac_id":"0244396265"}]},"enumeration_date":"2008-11-11","last_updated":"2010-11-18","_meta":{"source":"NPPES","snapshot_date":"2010-11-18","doc_url":"https://findmynpi.com/api"}}