Jerry P Moore, PHARMD
Individual provider Active NPI Pharmacist · Seagrove, NC
NPI 1154723070 · NPPES record last updated Sep 23, 2014
Key facts
- NPI
- 1154723070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14929 (NC)
- Practice address
- 510 N Broad St
Seagrove, NC 27341-8583 - Phone
- (336) 873-8246
- Fax
- (336) 873-8608
- NPI assigned
- Sep 23, 2014
- Sex
- Male
- 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 |
|---|---|---|---|
| 14929 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seagrove Associates LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14929 | NC | Yes |
Addresses
Primary practice location
510 N Broad St
Seagrove, NC 27341-8583
Mailing address
510 N Broad St
Seagrove, NC 27341-8583
Phone (336) 873-8246
Other providers in Seagrove, NC
- Linda Sue Franklin
- John F Gage
- Andrea Holland
- Hailey King
- Allen Anthony McCanless
- Pleasant Hill Homeplace
- Holly Poole
- Randolph Specialty Group Practice
- Seagrove Associates LLC
- Seagrove Medical Clinic, P.a.
All providers in Seagrove, NC · Pharmacist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2014. 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.