Healthcare Provider Details

I. General information

NPI: 1275533374
Provider Name (Legal Business Name): ANGELA MOORE-JONES PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33151 HIGHWAY 43
THOMASVILLE AL
36784-1634
US

IV. Provider business mailing address

33151 HIGHWAY 43
THOMASVILLE AL
36784-1634
US

V. Phone/Fax

Practice location:
  • Phone: 334-636-4616
  • Fax: 334-636-4616
Mailing address:
  • Phone: 334-636-4616
  • Fax: 334-636-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14197
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: