Active NPI
Bridget Moore
- Pharmacy Technician
- Weiser, ID
National Provider Identifier
1164047635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- TT53978
- Practice address
- 1545 E 6TH St
Weiser, ID 83672-1495 - Phone
- (208) 549-8777
- Fax
- (866) 273-1121
- NPI assigned
- Jun 10, 2020
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | TT53978 | ID | Primary |
Addresses
Primary practice location
1545 E 6TH St
Weiser, ID 83672-1495
Mailing address
1545 E 6TH St
Weiser, ID 83672-1495
Phone (208) 549-8777
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
| License | State | Type | Specialty |
|---|---|---|---|
| TT53978 | ID | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1164047635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 E 6TH ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836721495",
"telephone_number": "208-549-8777",
"fax_number": "866-273-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 E 6TH ST",
"city": "WEISER",
"state": "ID",
"postal_code": "836721495",
"telephone_number": "208-549-8777",
"fax_number": "866-273-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BRIDGET",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-10",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "ID",
"license": "TT53978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weiser, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.