Individual provider Active NPI

Lawrence Christopher Moore

  • Pharmacist
  • Chandler, AZ
National Provider Identifier
1558058578
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S018197 Issued in AZ
Practice address
485 N Juniper Dr Ste 2
Chandler, AZ 85226-2543
Phone
(602) 366-6904
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S018197 AZ Primary

Addresses

Primary practice location

485 N Juniper Dr Ste 2
Chandler, AZ 85226-2543

Mailing address

3113 E Daley LN
Phoenix, AZ 85050-8299
Phone (760) 877-7437

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

State licenses

LicenseStateTypeSpecialty
S018197AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Infusion Services 308, LLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

485 N Juniper Dr
Ste 2
Chandler, AZ 85226
Phone (602) 366-6904

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1558058578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 E DALEY LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850508299",
            "telephone_number": "760-877-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 N JUNIPER DR STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262543",
            "telephone_number": "602-366-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAWRENCE",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.