Individual provider Active NPI

Abel Txonbeng Moua

  • Pharmacist
  • Gaffney, SC
National Provider Identifier
1174830756
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH12861 Issued in SC
Practice address
1320 W Floyd Baker Blvd
Gaffney, SC 29341-1416
Phone
(864) 489-3129
Fax
(864) 488-1248
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH12861 SC Primary
Pharmacist 183500000X PH232761 MA

Addresses

Primary practice location

1320 W Floyd Baker Blvd
Gaffney, SC 29341-1416

Mailing address

341 Joe H Stephens Rd
Chesnee, SC 29323-8570
Phone (864) 578-9631

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
PH232761MAMDPharmacist
PH12861SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cowpens Community Pharmacy Current 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.

NPI Registry JSON

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1174830756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 JOE H STEPHENS RD",
            "city": "CHESNEE",
            "state": "SC",
            "postal_code": "293238570",
            "telephone_number": "864-578-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W FLOYD BAKER BLVD",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293411416",
            "telephone_number": "864-489-3129",
            "fax_number": "864-488-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUA",
        "first_name": "ABEL",
        "middle_name": "TXONBENG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "PH12861",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH232761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaffney, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2010; 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.