Healthcare Provider Details

I. General information

NPI: 1992440663
Provider Name (Legal Business Name): HILDRED MILDRED MOYO D PHARM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. HILDRED MOYO

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 LINCOLN WAY E
CHAMBERSBURG PA
17201-2817
US

IV. Provider business mailing address

5249 CARROLL WAREHIME RD
MANCHESTER MD
21102-3115
US

V. Phone/Fax

Practice location:
  • Phone: 717-261-1703
  • Fax:
Mailing address:
  • Phone: 443-707-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP453833
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: