Allen Michael Moore, PHARMD
Individual provider Active NPI Pharmacist · Youngtown, AZ
NPI 1992257539 · NPPES record last updated Oct 31, 2016
Key facts
- NPI
- 1992257539
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- S022238 (AZ)
- Practice address
- 10727 W. Olive Ave.
Youngtown, AZ 85363 - Phone
- (623) 815-8074
- NPI assigned
- Oct 31, 2016
- 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 |
|---|---|---|---|
| S022238 | AZ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S022238 | AZ | Yes |
Addresses
Primary practice location
10727 W. Olive Ave.
Youngtown, AZ 85363
Mailing address
21973 N 102ND LN Lot 411
Peoria, AZ 85383-2693
Phone (623) 866-8684
Other providers in Youngtown, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2016. 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.