Grover Cleveland Moseley III, RPH
Individual provider Active NPI Pharmacist · Snellville, GA
NPI 1235733528 · NPPES record last updated Nov 26, 2020
Key facts
- NPI
- 1235733528
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 013217 (GA)
- Practice address
- 1960 Main St E
Snellville, GA 30078-6466 - Phone
- (770) 972-4448
- NPI assigned
- Nov 26, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 013217 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia CVS Pharmacy, L.L.C. | Past |
Accepting new patients | |
| Georgia CVS Pharmacy L.L.C | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 013217 | GA | Yes |
Addresses
Primary practice location
1960 Main St E
Snellville, GA 30078-6466
Mailing address
1960 Main St E
Snellville, GA 30078-6466
Phone (770) 972-4448
Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2020. 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.