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General NPI Number Information
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NPI Number | 1730414756
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Entity Type | Individual
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Provider Name | DEBORAH MARIE MOES
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Gender | Female
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 10/08/2009
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Provider Practice Location Address
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Address Line | 5941 E MCKELLIPS RD
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City | MESA
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State | AZ
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Zip | 85215-2754
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Country | US
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Telephone | 480-830-6343
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Fax |
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Provider Business Mailing Address
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Address Line | 19759 E JULIUS RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-6660
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Country | US
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Telephone | 480-830-8187
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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 | S012046
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License Number State | AZ
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