Healthcare Provider Details

I. General information

NPI: 1811085251
Provider Name (Legal Business Name): DAVID JOSEPH MOYER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 VETERANS AVE
BATH NY
14810-0810
US

IV. Provider business mailing address

9813 FLEET RD
HAMMONDSPORT NY
14840-9761
US

V. Phone/Fax

Practice location:
  • Phone: 607-664-4413
  • Fax: 607-664-4461
Mailing address:
  • Phone: 607-583-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number029606
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: