Active NPI
Madison Rose Moore
- Pharmacist
- Bangor, ME
National Provider Identifier
1679306971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR72130
- Practice address
- 900 Stillwater Ave
Bangor, ME 04401-3602 - Phone
- (207) 947-5811
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR72130 | ME | Primary |
Addresses
Primary practice location
900 Stillwater Ave
Bangor, ME 04401-3602
Mailing address
280 Main Rd Apt 2
Milford, ME 04461-3242
Phone (207) 248-2488
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
| License | State | Type | Specialty |
|---|---|---|---|
| PR72130 | ME | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1679306971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 MAIN RD APT 2",
"city": "MILFORD",
"state": "ME",
"postal_code": "044613242",
"telephone_number": "207-248-2488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013602",
"telephone_number": "207-947-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MADISON",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2024-08-22",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR72130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.