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General NPI Number Information
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NPI Number | 1942563051
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Entity Type | Individual
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Provider Name | LEE ANN MOORE RPH
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Gender | Female
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 4101 W VERNON AVE
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City | KINSTON
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State | NC
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Zip | 28504-9672
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Country | US
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Telephone | 252-527-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 909 WEST RD
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City | KINSTON
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State | NC
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Zip | 28501-3662
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Country | US
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Telephone | 910-262-5909
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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 | 12520
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License Number State | NC
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