Rodney L Moore

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02178 Issued in MS

Legal business name

RODNEY L MOORE

Doing business as

Moore's Pharmacy

Practice address

16831 Hwy 21 S
Sebastopol, MS 39359

Phone

(601) 625-7158

Fax

(601) 625-9480

NPI assigned

May 7, 2007

Last updated

Oct 8, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brett C Moore, PHARMDNPI 1154955003

Title

Pharmacy Operations Manager

Phone

(601) 706-5417

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Moore's Pharmacy Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brett Chapin Moore, PHARMD

  • Pharmacist
  • Lena, MS
  • NPI 1154955003
  Authorized official Same address or phone

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1053524009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "SEBASTOPOL",
            "state": "MS",
            "postal_code": "393590289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16831 HWY 21 S",
            "city": "SEBASTOPOL",
            "state": "MS",
            "postal_code": "39359",
            "telephone_number": "601-625-7158",
            "fax_number": "601-625-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODNEY L MOORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS MANAGER",
        "authorized_official_telephone_number": "601-706-5417",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "02178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030128",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2511473",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moore's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benita Joetta Myles, MD
• Gaydon Nowell, M.S.N PMHNP-BC
• Candace Tierra Pearson, APRN, FNP-C
• Kayti A Powell, CPNP
• Karen Reece, FNP
• Reathia Sue Summers, FNP
• Whitney Marie Talbert, D.M.D.
• Mary Rose Thomas, PMHNP
• John Edwin Witcher, MD

• Community/Retail Pharmacy in Sebastopol, MS
• Providers in Sebastopol, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.