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General NPI Number Information
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NPI Number | 1114962594
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Entity Type | Organization
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Legal Business Name | MOORE'S PHARMACY INC.
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 200 S RACHAL ST
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City | SINTON
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State | TX
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Zip | 78387-2524
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Country | US
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Telephone | 361-364-1416
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Fax | 361-364-5028
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Provider Business Mailing Address
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Address Line | 200 S RACHAL ST
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City | SINTON
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State | TX
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Zip | 78387-2524
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Country | US
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Telephone | 361-364-1416
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Fax | 361-364-5028
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Authorized Official
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Title or Position | PRESIDENT
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Name | KELBY DAIN GORMAN
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Credential | RPH
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Telephone | 361-853-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 01945
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 01945
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 01945
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License Number State | TX
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