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NPI Code Detail

MEDICARE: JAMES MOYNIHAN PHARMD

MEDICARE: JAMES MOYNIHAN PHARMD
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
1183500000XPharmacist26022866AIN

General Provider Information

NPI Number : 1285928648
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MOYNIHAN PHARMD
Provider Business Mailing Address
First Line : 4850 E SOUTHPORT RD
Second Line : T-1789
City : INDIANAPOLIS
State : IN
Zip : 46237-3321
Country : US
Telephone Number : 317-787-6285
Fax Number : 317-787-6285
Provider Business Practice Location Address
First Line : 4850 E SOUTHPORT RD
Second Line : T-1789
City : INDIANAPOLIS
State : IN
Zip : 46237-3321
Country : US
Telephone Number : 317-787-6285
Fax Number : 317-787-6285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2011
Last Update Date : 06/02/2011

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