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General NPI Number Information
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NPI Number | 1114218286
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Entity Type | Individual
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Provider Name | MICHAEL LEO MOORE RPH
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Gender | Male
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 2870 S COLORADO BLVD
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City | DENVER
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State | CO
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Zip | 80222-6618
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Country | US
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Telephone | 303-757-2365
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Fax |
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Provider Business Mailing Address
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Address Line | 9812 CLAIRTON PL
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-4530
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Country | US
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Telephone | 303-470-8361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12574
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License Number State | CO
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