Active NPI
Coey Moore
- Pharmacist
- Brookhaven, PA
National Provider Identifier
1801564166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP455672
- Practice address
- 4098 Edgmont Ave
Brookhaven, PA 19015-2211 - Phone
- (610) 876-8815
- NPI assigned
- Sep 1, 2021
- Sex
- Male
- 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 | RP455672 | PA | Primary |
Addresses
Primary practice location
4098 Edgmont Ave
Brookhaven, PA 19015-2211
Mailing address
3807 Berleigh Hill CT
Burtonsville, MD 20866-1394
Phone (240) 506-1119
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 |
|---|---|---|---|
| RP455672 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Take Care Health Pennsylvania, PC | Current | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Locations
4098 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-8815
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Nurse Practitioner
- Rochester, PA
- NPI 1922050384
-
- Pharmacy
- Brookhaven, PA
- NPI 1215942206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1801564166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3807 BERLEIGH HILL CT",
"city": "BURTONSVILLE",
"state": "MD",
"postal_code": "208661394",
"telephone_number": "240-506-1119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4098 EDGMONT AVE",
"city": "BROOKHAVEN",
"state": "PA",
"postal_code": "190152211",
"telephone_number": "610-876-8815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "COEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP455672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.