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NPI Code Detail

MEDICARE: CHASE MOORE

MEDICARE: CHASE MOORE
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
1183500000XPharmacist015109KY

General Provider Information

NPI Number : 1679173330
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHASE MOORE
Provider Business Mailing Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-678-7350
Fax Number : 270-678-7706
Provider Business Practice Location Address
First Line : 2345 HAPPY VALLEY RD
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8076
Country : US
Telephone Number : 270-678-7350
Fax Number : 270-678-7706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2020
Last Update Date : 10/30/2020

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Directions to “ CHASE MOORE ” Practice Location

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