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General NPI Number Information
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NPI Number | 1134205008
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Entity Type | Organization
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Legal Business Name | MOORE HEALTH INC.
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 1400 EATONTON RD SUITE 600
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City | MADISON
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State | GA
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Zip | 30650-4642
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Country | US
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Telephone | 706-342-2070
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Fax | 706-342-9159
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Provider Business Mailing Address
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Address Line | 1400 EATONTON RD SUITE 600
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City | MADISON
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State | GA
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Zip | 30650
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Country | US
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Telephone | 706-342-2070
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Fax | 706-342-9159
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM DAVID MOORE SR.
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Credential | RPH
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Telephone | 706-342-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 008269
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License Number State | GA
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