Moore Healthcare, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MOORE HEALTHCARE, INC.

Doing business as

Palace Drug Store

Practice address

301 N Broadway St
Cleveland, OK 74020-3421

Phone

(918) 358-2524

Fax

(918) 358-2588

NPI assigned

Jan 22, 2007

Organization subpart

No

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

Authorized official

Name

Gregory P Moore

Title

Manager

Phone

(918) 358-2587

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• PALACE DRUG STORE Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1417001272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203421",
            "telephone_number": "918-358-2524",
            "fax_number": "918-358-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N BROADWAY ST",
            "city": "CLEVELAND",
            "state": "OK",
            "postal_code": "740203421",
            "telephone_number": "918-358-2524",
            "fax_number": "918-358-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "918-358-2587"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OK",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "OK",
            "license": "52-4094",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "OK",
            "license": "52-S-1138",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "52-4094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100811860A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100811860B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100811860",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NCPDP NUMBER",
            "identifier": "3700499",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALACE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PALACE DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Markishia Miller
• Paige McKenzie Miller
• Sean Patrick Mills, MSN, APRN, FNP-C
• Dakota Blane Mooney, DPT
• Moore Healthcare Inc (Palace Drug Store)
• Moore Healthcare, Inc.
• Jeffrey Edward Moore, DPH
• Clinton Ray Moser Jr., MS
• Patricia Ann Murphy
• Lily Muse

• Durable Medical Equipment & Medical Supplies in Cleveland, OK
• Providers in Cleveland, OK by specialty
• Durable Medical Equipment & Medical Supplies in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.