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General NPI Number Information
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NPI Number | 1942523873
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Entity Type | Individual
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Provider Name | GREGG MOFFETT PHARM. D
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Gender | Male
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Dates
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Enumeration Date | 03/06/2010
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Last Update Date | 03/06/2010
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Provider Practice Location Address
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Address Line | 4401 BUFFALO RD
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City | ERIE
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State | PA
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Zip | 16510-2202
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Country | US
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Telephone | 814-898-1323
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Fax | 814-898-1587
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Provider Business Mailing Address
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Address Line | 1618 W 32ND ST
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City | ERIE
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State | PA
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Zip | 16508-2204
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Country | US
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Telephone |
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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 | RP441985
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License Number State | PA
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