Randall R Moore, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

P3855 Issued in ID

Practice address

720 16TH Ave
Lewiston, ID 83501-3768

Phone

(208) 743-5528

Fax

(208) 746-2785

NPI assigned

Dec 22, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669537304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19054 PINE RIDGE LN",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015274",
            "telephone_number": "208-798-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 16TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013768",
            "telephone_number": "208-743-5528",
            "fax_number": "208-746-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RANDALL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P3855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NO",
            "identifier": "P3855",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garrett Alan Mockler, MD
• Shayleigh Montgomery, FNP-C
• Neil Mooney, RN
• Julie Moore-Fisher, D.C.
• Amanda Caye Moore, DNP
• Lois Elizabeth Moree, LMT
• Christopher Al Moreno, M.D.
• Clinton R Morgan, MD
• John Carl Morgenstern, M.D.
• Wendy Elizabeth Morley, CRNA

• Pharmacist in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Pharmacist in Idaho

• 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.

Verify at the official NPI Registry.