MEDICARE: MOXY RX LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1649907197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOXY RX LLC

Provider Business Mailing Address
First Line	:	PO BOX 26492
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35260-0492
Country	:	US
Telephone Number	:	205-829-1350
Fax Number	:	205-829-1355

Provider Business Practice Location Address
First Line	:	754 SHADES MOUNTAIN PLZ
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35226-1513
Country	:	US
Telephone Number	:	205-829-1350
Fax Number	:	205-829-1355

Authorized Official
Title or Position	:	COMPLIANCE OFFICER
Name	:	JOSH HARDIN
Credential	:	PHARMD
Telephone Number	:	205-871-9007

Provider Enumeration Date	:	08/04/2022
Last Update Date	:	08/04/2022

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Directions to “MOXY RX LLC ” Practice Location

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