Active NPI
Kor Moua
- Pharmacist
- Fitchburg, MA
National Provider Identifier
1700149754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH233710
- Practice address
- 140 Whalon St
Fitchburg, MA 01420-7158 - Phone
- (978) 345-7540
- NPI assigned
- Jun 23, 2012
- 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 | PH233710 | MA | Primary |
Addresses
Primary practice location
140 Whalon St
Fitchburg, MA 01420-7158
Mailing address
44 Highland Ave
Fitchburg, MA 01420-7815
Phone (978) 870-5502
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 |
|---|---|---|---|
| PH233710 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340409600000",
"number": "1700149754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 HIGHLAND AVE",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014207815",
"telephone_number": "978-870-5502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 WHALON ST",
"city": "FITCHBURG",
"state": "MA",
"postal_code": "014207158",
"telephone_number": "978-345-7540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUA",
"first_name": "KOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-23",
"last_updated": "2012-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH233710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.