MEDICARE: DR. MICHAEL MORO 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
1	183500000X	Pharmacist	23080	CO

General Provider Information

NPI Number	:	1427631316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL MORO PHARMD

Provider Business Mailing Address
First Line	:	203 S ROLLIE AVE
Second Line	:
City	:	FORT LUPTON
State	:	CO
Zip	:	80621-1508
Country	:	US
Telephone Number	:	303-892-6401
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 S ROLLIE AVE
Second Line	:
City	:	FORT LUPTON
State	:	CO
Zip	:	80621-1508
Country	:	US
Telephone Number	:	303-892-6401
Fax Number	:

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

Provider Enumeration Date	:	04/29/2021
Last Update Date	:	04/29/2021

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