MEDICARE: ANNA NGUYEN MOYER PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS49455	FL
2	183500000X	Pharmacist	16513	NC
3	1835G0303X	Geriatric Pharmacist	PU7240	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083936462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA NGUYEN MOYER PHARM.D.

Provider Business Mailing Address
First Line	:	145 HILDEN RD STE 102
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-8401
Country	:	US
Telephone Number	:	904-600-4099
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 HILDEN RD STE 102
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-8401
Country	:	US
Telephone Number	:	904-600-4099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	09/21/2021

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