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NPI Code Detail

MEDICARE: ALEX GRAHAM MORENO RPH

MEDICARE: ALEX GRAHAM MORENO RPH
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
1183500000XPharmacistPHA21384CO
2183500000XPharmacist18510-40WI
3183500000XPharmacist3949WY

General Provider Information

NPI Number : 1538605886
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX GRAHAM MORENO RPH
Provider Business Mailing Address
First Line : 228 E 42ND ST
Second Line :
City : LOVELAND
State : CO
Zip : 80538-2327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 205 E EISENHOWER BLVD
Second Line :
City : LOVELAND
State : CO
Zip : 80537-3909
Country : US
Telephone Number : 970-669-4444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2017
Last Update Date : 01/10/2017

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Directions to “ ALEX GRAHAM MORENO RPH” Practice Location

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