MEDICARE: NANCY TODD MOORE R.PH.

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	6592	NC

General Provider Information

NPI Number	:	1689970451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY TODD MOORE R.PH.

Provider Business Mailing Address
First Line	:	5116 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1420
Country	:	US
Telephone Number	:	919-471-3933
Fax Number	:	919-471-6372

Provider Business Practice Location Address
First Line	:	5116 N ROXBORO ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-1420
Country	:	US
Telephone Number	:	919-471-3933
Fax Number	:	919-471-6372

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

Provider Enumeration Date	:	01/26/2011
Last Update Date	:	01/26/2011

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