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NPI Code Detail

MEDICARE: PATRICK MOORE BSPHARM, PHARMD

MEDICARE: PATRICK MOORE BSPHARM, 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
1183500000XPharmacistRP005844WV

General Provider Information

NPI Number : 1669089090
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK MOORE BSPHARM, PHARMD
Provider Business Mailing Address
First Line : 200 EMILY DR
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-5500
Country : US
Telephone Number : 304-918-6056
Fax Number : 304-918-6039
Provider Business Practice Location Address
First Line : 200 EMILY DR
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-5500
Country : US
Telephone Number : 304-918-6056
Fax Number : 304-918-6039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 09/29/2020

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