Individual provider Active NPI

William R Moore, PHARM D

  • Pharmacist
  • Milledgeville, GA
National Provider Identifier
1003106550
Registry record updated Apr 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH022278 Issued in GA
Practice address
2400 N Columbia St
Milledgeville, GA 31061-2069
Phone
(478) 452-3589
NPI assigned
Apr 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH022278 GA Primary

Addresses

Primary practice location

2400 N Columbia St
Milledgeville, GA 31061-2069

Mailing address

2400 N Columbia St
Ste 13
Milledgeville, GA 31061-2069
Phone (478) 452-3589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH022278GAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302998400000",
    "number": "1003106550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 N COLUMBIA ST",
            "address_2": "STE 13",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612069",
            "telephone_number": "478-452-3589",
            "fax_number": "478-451-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612069",
            "telephone_number": "478-452-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-17",
        "last_updated": "2011-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH022278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.