Moodycare Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHRE004996 Issued in GA

Legal business name

MOODYCARE INC.

Doing business as

Coliseum Park Professional Pharmacy

Practice address

380 Hospital Dr.
Ste 175-a
Macon, GA 31217

Phone

(478) 745-5431

Fax

(478) 765-4359

NPI assigned

Mar 15, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Benjamin Moody III, RPHNPI 1366464604

Title

President

Phone

(478) 745-5431

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coliseum Park Professional Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Benjamin Moody III, RPH.

  • Pharmacist
  • Macon, GA
  • NPI 1366464604
  NPD (past) Authorized official

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912976630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR.",
            "address_2": "STE 175-A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-745-5431",
            "fax_number": "478-765-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR.",
            "address_2": "STE 175-A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-745-5431",
            "fax_number": "478-765-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOODYCARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-745-5431",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "GA",
            "license": "PHRE004996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP OR NABP NUMBER",
            "identifier": "1122376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coliseum Park Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sebastian Alan Montgomery, MD
• Kathleen Montlouis
• Chase Moody
• Melissa Moody, OTA
• Robert Benjamin Moody III, RPH.
• Heeseo Moon
• Moore Foot and Ankle Solutions, LLC
• Aubrey Moore
• Ba'Sharra Aneka Moore, NP
• Carita Q. Moore

• Pharmacy in Macon, GA
• Providers in Macon, GA by specialty
• Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.