Active NPI
Robert Charles Moore, R.PH.
- Pharmacist
- Eagle River, AK
National Provider Identifier
1053543322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1580
- Practice address
- 17452 Kahiltna Dr
Eagle River, AK 99577-8127 - Phone
- (907) 240-2215
- NPI assigned
- Aug 20, 2009
- Last updated
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1580 | AK | Primary |
Addresses
Primary practice location
17452 Kahiltna Dr
Eagle River, AK 99577-8127
Mailing address
17452 Kahiltna Dr
Eagle River, AK 99577-8127
Phone (907) 240-2215
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1580 | AK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1053543322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17452 KAHILTNA DR",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995778127",
"telephone_number": "907-240-2215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17452 KAHILTNA DR",
"city": "EAGLE RIVER",
"state": "AK",
"postal_code": "995778127",
"telephone_number": "907-240-2215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ROBERT",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AK",
"license": "1580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle River, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.