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General NPI Number Information
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NPI Number | 1992440663
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Entity Type | Individual
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Provider Name | HILDRED MILDRED MOYO D PHARM
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Gender | Female
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 949 LINCOLN WAY E
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-2817
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Country | US
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Telephone | 717-261-1703
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Fax |
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Provider Business Mailing Address
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Address Line | 5249 CARROLL WAREHIME RD
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City | MANCHESTER
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State | MD
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Zip | 21102-3115
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Country | US
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Telephone | 443-707-0850
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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 | RP453833
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License Number State | PA
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