Healthcare Provider Details

I. General information

NPI: 1477570364
Provider Name (Legal Business Name): MOYES PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3798 HIGHWAY 42
LOCUST GROVE GA
30248-3632
US

IV. Provider business mailing address

PO BOX 580
MCDONOUGH GA
30253-0580
US

V. Phone/Fax

Practice location:
  • Phone: 770-957-6004
  • Fax: 770-914-0961
Mailing address:
  • Phone: 770-957-6004
  • Fax: 770-914-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7732
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LOREN B PIERCE
Title or Position: PHARMACIST/OWNER
Credential: RPH
Phone: 770-957-6004