Wade Lucas Moore, PHARMD

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

17258 Issued in AL

Practice address

3952 US Highway 80 W
Phenix City, AL 36870-6523

Phone

(334) 214-9129

Fax

(334) 214-9640

NPI assigned

Aug 3, 2015

Last updated

Aug 3, 2015By 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

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.

• The Moore Drugstore

  • Pharmacy
  • Phenix City, AL
  • NPI 1760229264
  NPD Authorized official

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1588040463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 US HIGHWAY 80 W",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368706523",
            "telephone_number": "334-214-9129",
            "fax_number": "334-214-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3952 US HIGHWAY 80 W",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368706523",
            "telephone_number": "334-214-9129",
            "fax_number": "334-214-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WADE",
        "middle_name": "LUCAS",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "AL",
            "license": "17258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tori Simone Moffett
• Maxon Paul Moncrief
• Tammy Wynett Montgomery, MENTAL HEALTH
• Moon Lake Emergency Physicians LLC
• Sasha Ladon Moore, LMSW
• Alicia Lynn Morris, NP
• Richard Chase Morris, LPC
• Sheena Janea Morris
• Jordan Moses, ATC, CSCS, USAW
• John Barson Moulton II, PHARM. D.

• Pharmacotherapy Pharmacist in Phenix City, AL
• Providers in Phenix City, AL by specialty
• Pharmacotherapy Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.