{
"Npi": {
"NPI": "1679617492",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MOORE HEALTHCARE, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "301 N BROADWAY ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLEVELAND",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74020-3421",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-358-2587",
"MailingAddressFaxNumber": "918-358-2588",
"FirstLinePracticeLocationAddress": "301 N BROADWAY ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLEVELAND",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74020-3421",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-358-2587",
"PracticeLocationAddressFaxNumber": "918-358-2588",
"EnumerationDate": "02/16/2007",
"LastUpdateDate": "09/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "GARY",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPH.",
"AuthorizedOfficialTelephoneNumber": "918-358-2524",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "52-4094",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}