MEDICARE: DR. TIMOTHY EDWARD MOYER 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	PS0033556	FL

General Provider Information

NPI Number	:	1477796076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY EDWARD MOYER PHARMD

Provider Business Mailing Address
First Line	:	15264 SW 19TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4300
Country	:	US
Telephone Number	:	954-433-2732
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 N FEDERAL HWY
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6605
Country	:	US
Telephone Number	:	954-781-0442
Fax Number	:

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

Provider Enumeration Date	:	04/13/2009
Last Update Date	:	04/13/2009

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