Healthcare Provider Details

I. General information

NPI: 1952324915
Provider Name (Legal Business Name): MOYES PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 JONESBORO RD
MCDONOUGH GA
30253-3718
US

IV. Provider business mailing address

PO BOX 580
MCDONOUGH GA
30253-0580
US

V. Phone/Fax

Practice location:
  • Phone: 770-957-1853
  • Fax: 770-692-0419
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number8892
License Number StateGA

VIII. Authorized Official

Name: TAYLOR RICE
Title or Position: OWNER
Credential: RPH
Phone: 770-957-1853