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General NPI Number Information
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NPI Number | 1164514196
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Entity Type | Organization
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Legal Business Name | ROBERT T. MOSS, JR DBA MOSS PHARMACY
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 804 2ND LOOP RD STE E
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City | FLORENCE
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State | SC
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Zip | 29505-2827
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Country | US
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Telephone | 843-665-0289
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Fax | 843-667-9964
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Provider Business Mailing Address
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Address Line | 804 2ND LOOP RD STE E
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City | FLORENCE
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State | SC
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Zip | 29505-2827
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Country | US
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Telephone | 843-665-0289
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Fax | 843-667-9964
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | ROBERT T MOSS JR.
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Credential | PHARMACIST
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Telephone | 843-665-0289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50001280
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License Number State | SC
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