Individual provider Active NPI

Moges K Tekle, VA PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Fredericksburg, VA
National Provider Identifier
1093989592
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
0202206386 Issued in VA
Practice address
2567 Cowan Blvd
Fredericksburg, VA 22401-8440
Phone
(540) 479-1405
Fax
(540) 370-8990
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0202206386 VA Primary

Addresses

Primary practice location

2567 Cowan Blvd
Fredericksburg, VA 22401-8440

Mailing address

2567 Cowan Blvd
Fredericksburg, VA 22401-8440
Phone (540) 479-1405

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
0202206386VAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericksburg City Pharmacy Inc Current Accepting new patients

Locations

2567 Cowan Blvd
Fredericksburg, VA 22401
Phone (540) 479-1405

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1093989592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2567 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018440",
            "telephone_number": "540-479-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2567 COWAN BLVD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018440",
            "telephone_number": "540-479-1405",
            "fax_number": "540-370-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLE",
        "first_name": "MOGES",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "VA PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VA",
            "license": "0202206386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.