Wade Oliver Moulton, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

4907684-1701 Issued in UT

Practice address

1080 W Hwy 40
Vernal, UT 84078

Phone

(435) 789-7235

NPI assigned

Oct 28, 2019

Last updated

Oct 28, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smiths Food & Drug Centers Inc

  dba Smiths Pharmacy #82

  • Community/Retail Pharmacy
  • Vernal, UT
  • NPI 1962427591
  NPD
• Smith's Food & Drug Centers Inc

  dba Smith's Pharmacy #303

  • Community/Retail Pharmacy
  • Henderson, NV
  • NPI 1881585248
  NPD (past)

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1205479748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 W 1070 S",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840784770",
            "telephone_number": "435-789-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 W HWY 40",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "84078",
            "telephone_number": "435-789-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "WADE",
        "middle_name": "OLIVER",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "4907684-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Lee Monfredi, DDS
• Dena Coltharp Moore
• Justin Morgan, DDS
• Thomas Jason Morrell, PHARM-D
• Terie Morris, MSN, FNP
• Mountain Valley Imaging of Eastern Utah LLC
• Mountainlands Community Health Center Inc
• Mountainlands Community Health Center Inc (Mountainlands - Vernal Pharmacy)
• Mountainlands Community Health Center, Inc.
• Kameron Murray, LCSW

• Pharmacist in Vernal, UT
• Providers in Vernal, UT by specialty
• Pharmacist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; 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.