Kelsey Moody, PHARMD

Individual provider Active NPI Pharmacist · Bellaire, MI

NPI 1003528449 · NPPES record last updated Dec 16, 2022

Key facts

NPI
1003528449
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
5302041999 (MI)
Practice address
211 S Division St
Bellaire, MI 49615-9550
Phone
(231) 533-5534
Fax
(231) 533-5725
NPI assigned
Dec 16, 2022
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302041999MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prevos Family Markets LLC Past
since Dec 18, 2022
Accepting new patients
Prevos Family Markets LLC Past
since Dec 18, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302041999 MI Yes

Addresses

Primary practice location

211 S Division St
Bellaire, MI 49615-9550

Mailing address

PO Box 918
Bellaire, MI 49615-0918
Phone (231) 533-5534

Other providers in Bellaire, MI

All providers in Bellaire, MI · Pharmacist in Michigan

Sources for this page

Verify at the official NPI Registry.