Andrew Moore, PHARM-D
Individual provider Active NPI Pharmacist · Augusta, AR
NPI 1790312296 · NPPES record last updated Mar 25, 2020
Key facts
- NPI
- 1790312296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD14760 (AR)
- Practice address
- 601 Main St
Augusta, AR 72006-2444 - Phone
- (870) 347-2620
- Fax
- (870) 347-2624
- NPI assigned
- Mar 25, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD14760 | AR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD14760 | AR | Yes |
Addresses
Primary practice location
601 Main St
Augusta, AR 72006-2444
Mailing address
PO Box 497
Augusta, AR 72006-0497
Phone (870) 347-2534
Other providers in Augusta, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.