Active NPI
Walter H. Moore, BS PHARM
- Pharmacist
- Yuma, AZ
National Provider Identifier
1407938434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH011715
- Practice address
- 1175 Shaw Street
Yuma, AZ 85369-9116 - Phone
- (928) 269-3177
- Fax
- (928) 269-0890
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH011715 | GA | Primary |
Addresses
Primary practice location
1175 Shaw Street
Yuma, AZ 85369-9116
Mailing address
1337 S 41St Ave
Yuma, AZ 85364-4032
Phone (928) 782-6751
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
- Credentials
- Bachelor of Science, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH011715 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407938434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1337 S 41ST AVE",
"city": "YUMA",
"state": "AZ",
"postal_code": "853644032",
"telephone_number": "928-782-6751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 SHAW STREET",
"city": "YUMA",
"state": "AZ",
"postal_code": "853699116",
"telephone_number": "928-269-3177",
"fax_number": "928-269-0890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "WALTER",
"middle_name": "H.",
"credential": "BS PHARM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH011715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.