Individual provider Active NPI

Toni Garner Moore, PHARMACIST

  • Pharmacist
  • Hartsville, SC
National Provider Identifier
1114552213
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8714 Issued in SC
Practice address
901 S 5TH St
Hartsville, SC 29550-5739
Phone
(843) 332-4523
NPI assigned
Mar 9, 2020
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8714 SC Primary

Addresses

Primary practice location

901 S 5TH St
Hartsville, SC 29550-5739

Mailing address

3031 Spring Fancy LN
Indian Trail, NC 28079-5233
Phone (704) 821-4205

Other identifiers 2

IdentifierTypeStateIssuer
15572OtherNCBOARD OF PHARMACY
8714OtherSCBOARD OF PHARMACY

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

State licenses

LicenseStateTypeSpecialty
8714SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 13, 2022 Accepting new patients
Walgreen Co PastSince Mar 16, 2020 Accepting new patients

Locations

901 S 5th St
Hartsville, SC 29550
Phone (843) 332-4523

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1114552213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 SPRING FANCY LN",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280795233",
            "telephone_number": "704-821-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 5TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295505739",
            "telephone_number": "843-332-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TONI",
        "middle_name": "GARNER",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "8714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "15572",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "8714",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.