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General NPI Number Information
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NPI Number | 1952489460
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Entity Type | Organization
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Legal Business Name | MOORES PHARMACY LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/19/2017
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Provider Practice Location Address
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Address Line | 3041 ENSLEY 5 POINTS W AVE STE D
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City | BIRMINGHAM
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State | AL
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Zip | 35208-2719
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Country | US
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Telephone | 205-785-4223
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Fax | 205-785-4225
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Provider Business Mailing Address
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Address Line | 3041 ENSLEY 5 POINTS W AVE STE D
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City | BIRMINGHAM
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State | AL
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Zip | 35208-2719
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Country | US
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Telephone | 205-785-4223
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Fax | 205-785-4225
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | REGINALD MOORE
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Credential | BS
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Telephone | 205-907-3840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 112873
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License Number State | AL
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