CANNON PHARMACY OF MOORESVILLE
NPI 1811134869
Pharmacy - Community/Retail Pharmacy in Mooresville, NC
NPI Status: Active since January 13, 2009
Contact Information
521 E PLAZA DR
MOORESVILLE, NC
ZIP 28115
Phone: (704) 658-9870
Fax: (704) 658-9871
- Organization
- Pharmacy
- Community/Retail Pharmacy
- Medicare Supplier
- Does Not Accept Medicare Approved Payment
- CLIA Number: 34D2006936
- CLIA Cert. Type: Pharmacy
- CLIA Exp. Date: 05-04-2026
About CANNON PHARMACY OF MOORESVILLE
This page provides the complete NPI Profile along with additional information for Cannon Pharmacy Of Mooresville, a provider established in Mooresville, North Carolina operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1811134869 assigned on January 2009. The practitioner's primary taxonomy code is 3336C0003X with license number 10205 (NC). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Cannon Pharmacy Of Mooresville. The authorized official of this NPI record is Brian Freeman (President)
- NPI
- 1811134869
- Provider Legal Name
- LIVEWELL INC
- Other Organization Name
- CANNON PHARMACY OF MOORESVILLE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 521 E PLAZA DR MOORESVILLE, NC 28115
- Location Phone
- (704) 658-9870
- Location Fax
- (704) 658-9871
- Mailing Address
- 521 E PLAZA DR MOORESVILLE, NC 28115
- Mailing Phone
- (704) 658-9870
- Mailing Fax
- (704) 658-9871
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-13-2009
- Last Update Date
- 01-23-2013
- Code Navigator
Cannon Pharmacy Of Mooresville is a medicare supplier with PTAN 20482943 who does not accept Medicare assignment for all durable medical equipment and supplies. The provider may not accept the Medicare allowable as payment in full and may collect additional payment directly from the patient, and/or charge more than the Medicare allowable.The supplier carries the following product categories: Immunosuppressive Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Commodes, Urinals, Bedpans or Blood Glucose Monitors/Supplies (Non-Mail Order) or Heat & Cold Applications or Traction Equipment or (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies or Canes and/or Crutches or Walkers or Wheelchairs (Standard Manual) or Wheelchairs (Standard Manual Related Accessories) or Wheelchair Seating/Cushions or Orthoses: Off-The-Shelf or Penile Pumps or Ostomy Supplies or Urological Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Community/Retail Pharmacy
- Taxonomy Code
- 3336C0003X
- Type
- Suppliers
- License No.
- 10205
- License State
- NC
- Taxonomy Description
- A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3413274 | OTHER (01) | NCPDP PROVIDER IDENTIFICATION NUMBER |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20482943
- Accepts Medicare Assignment
- NO
- Specialities List
- Pharmacy.
- Competitive Bidding
- NO
Supplies List
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- Commodes, Urinals, Bedpans - Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
- Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
- Heat & Cold Applications - Heat therapy, Cold therapy, Heating pads
- Traction Equipment - Traction tables, Traction machines, Inversion tables
- (TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies - Transcutaneous Electrical Nerve Stimulation (TENS) for the relief of acute post-operative pain
- Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
- Walkers - Standard Walkers, Wheeled Walkers, Folding Walker
- Wheelchairs (Standard Manual) - Standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchairs (Standard Manual Related Accessories) - Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
- Wheelchair Seating/Cushions - Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
- Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
- Penile Pumps -
- Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
- Urological Supplies - Catheters, Urinary collection devices
- Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
- Surgical Dressings - Gauze, Elastic bandages, Adhesive tape
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2006936
- Facility Type
- Pharmacy
- Certificate Effective Date
- May 05, 2024
- Certificate Expiration Date
- May 04, 2026
- Laboratory Director
- RYAN T. YANICKO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Cannon Pharmacy Of Mooresville to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1811134869, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
MOORESVILLE, NC 28115
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811134869, enumerated as an "organization" on January 13, 2009.
The provider is located at 521 E PLAZA DR MOORESVILLE, NC 28115 and the phone number is (704) 658-9870.
Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
