Kathryn Moffat, PHARM. D
Individual provider Active NPI Pharmacist · Saint Ann, MO
NPI 1154604262 · NPPES record last updated Sep 27, 2011
Key facts
- NPI
- 1154604262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 2010022982 (MO)
- Practice address
- 10585 Saint Charles Rock Rd
Saint Ann, MO 63074-1817 - Phone
- (314) 427-1962
- Fax
- (314) 427-4514
- NPI assigned
- Sep 25, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010022982 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2010022982 | MO | Yes |
Addresses
Primary practice location
10585 Saint Charles Rock Rd
Saint Ann, MO 63074-1817
Mailing address
10585 Saint Charles Rock Rd
Saint Ann, MO 63074-1817
Phone (314) 427-1962
Other providers in Saint Ann, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.