Active NPI
Barbara Sue Moore, RPH
- Pharmacist
- Poland, OH
National Provider Identifier
1104308469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03117353
- Practice address
- 6615 Clingan Rd
Suite B
Poland, OH 44514 - Phone
- (330) 757-8787
- Fax
- (330) 757-0155
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- 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 | 03117353 | OH | Primary |
Addresses
Primary practice location
6615 Clingan Rd
Suite B
Poland, OH 44514
Mailing address
6615 Clingan Rd
Suite B
Poland, OH 44514
Phone (330) 757-8787
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 |
|---|---|---|---|
| 03117353 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethann Passarello Inc | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Poland, OH
- NPI 1972651933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1104308469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6615 CLINGAN RD",
"address_2": "SUITE B",
"city": "POLAND",
"state": "OH",
"postal_code": "44514",
"telephone_number": "330-757-8787",
"fax_number": "330-757-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 CLINGAN RD",
"address_2": "SUITE B",
"city": "POLAND",
"state": "OH",
"postal_code": "44514",
"telephone_number": "330-757-8787",
"fax_number": "330-757-0155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BARBARA",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03117353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.