Joan Mackenzie Moad, RPH
Individual provider Active NPI Pharmacist · Allison, IA
NPI 1184841876 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184841876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17364 (IA)
- Practice address
- 416 S Main St
Allison, IA 50602-0515 - Phone
- (319) 267-2626
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17364 | IA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17364 | IA | Yes |
Addresses
Primary practice location
416 S Main St
Allison, IA 50602-0515
Mailing address
416 South Main St
PO Box 515
Allison, IA 50602-0515
Phone (319) 267-2626
Other providers in Allison, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.