MEDICARE: DR. JEFFREY W. MOSER PHARM.D. R.P.

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	10617	NE

General Provider Information

NPI Number	:	1780706135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY W. MOSER PHARM.D. R.P.

Provider Business Mailing Address
First Line	:	2122 N 56TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-4246
Country	:	US
Telephone Number	:	402-558-1609
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 N 30TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68131-2137
Country	:	US
Telephone Number	:	402-449-4567
Fax Number	:

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

Provider Enumeration Date	:	04/05/2007
Last Update Date	:	07/08/2007

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