Healthcare Provider Details

I. General information

NPI: 1568789436
Provider Name (Legal Business Name): PAMELA MICHELLE MOYE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 04/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4066 HAMMOCK TRCE
ATLANTA GA
30349-8865
US

IV. Provider business mailing address

4066 HAMMOCK TRCE
ATLANTA GA
30349-8865
US

V. Phone/Fax

Practice location:
  • Phone: 678-519-2088
  • Fax:
Mailing address:
  • Phone: 678-519-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number023848
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17768
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: