Organization Active NPI

Med Fast Pharmacy LLC

  • Community/Retail Pharmacy
  • Martinsburg, WV
National Provider Identifier
1891890125
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
MP0552313 Issued in WV
Legal business name
MED FAST PHARMACY LLC
Doing business as
MOORES PHARMACY
Practice address
1311 Old Courthouse SQ
Martinsburg, WV 25404
Phone
(304) 264-0300
Fax
(304) 264-0224
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Moore, RPH
Title
President
Phone
(304) 264-0300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X MP0552313 WV Primary

Addresses

Primary practice location

1311 Old Courthouse SQ
Martinsburg, WV 25404

Mailing address

1311 Edwin Miller Blvd
Martinsburg, WV 25404-3703
Phone (304) 264-0300

Other identifiers 2

IdentifierTypeStateIssuer
6001323000MedicaidWV
2111505OtherPK

Other names 1

  • MOORES PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080908000092 WV Part B Supplier - Mass Immunization (Roster Biller Only) 0749356236 Practice locations: Martinsburg, WV

National Provider Directory

National Provider Directory

Locations

1311 Edwin Miller Blvd
Martinsburg, WV 25404
Phone (304) 264-0300

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1891890125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 EDWIN MILLER BLVD",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254043703",
            "telephone_number": "304-264-0300",
            "fax_number": "304-264-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 OLD COURTHOUSE SQ",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "25404",
            "telephone_number": "304-264-0300",
            "fax_number": "304-264-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED FAST PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-264-0300",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "MP0552313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001323000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOORES PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Martinsburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.