Active NPI
Moore'S Pharmacy Inc.
- Community/Retail Pharmacy
- Beeville, TX
National Provider Identifier
1649333469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 30113
- Legal business name
- MOORE'S PHARMACY INC.
- Practice address
- 1000 E Houston St
Beeville, TX 78102-5259 - Phone
- (361) 358-2811
- NPI assigned
- Dec 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kelby D Gorman, R.PH.
- Title
- Vice President
- Phone
- (361) 364-1416
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 30113 | TX | Primary |
Addresses
Primary practice location
1000 E Houston St
Beeville, TX 78102-5259
Mailing address
1000 E Houston St
Beeville, TX 78102-5259
Phone (361) 358-2811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143841 | Medicaid | TX |
Other names 1
- Moore's City Drug
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111109000362 | TX | Part B Supplier - Pharmacy | 1759398985 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Sinton, TX |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
1000 E Houston St
Beeville, TX 78102
Phone (361) 304-8771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250035200000",
"number": "1649333469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 E HOUSTON ST",
"city": "BEEVILLE",
"state": "TX",
"postal_code": "781025259",
"telephone_number": "361-358-2811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E HOUSTON ST",
"city": "BEEVILLE",
"state": "TX",
"postal_code": "781025259",
"telephone_number": "361-358-2811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOORE'S PHARMACY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-19",
"last_updated": "2009-08-12",
"status": "A",
"authorized_official_last_name": "GORMAN",
"authorized_official_first_name": "KELBY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "361-364-1416",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "R.PH."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "TX",
"license": "30113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143841",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Moore's City Drug",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Beeville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.