# MOFFETTRX LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ole Towne Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013631654
- **Authorized official:** RICHARD ANDREW MOFFETT PHARMD (OWNER/PIC)
- **Authorized official phone:** (601) 693-0033

## Contact information

- **Practice address:** 2000 24TH AVE, MERIDIAN, MS 39301-3120
- **Practice address phone:** (601) 693-0033
- **Practice address fax:** (601) 693-0062
- **Mailing address:** 2000 24TH AVE, MERIDIAN, MS 39301-3120
- **Mailing address phone:** (601) 693-0033
- **Mailing address fax:** (601) 693-0062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/27/2022
- **Last updated:** 09/27/2022