# MOORE FAMILY STORES INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Martinsville Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295810422
- **Authorized official:** TRENT MOORE (OWNER/PRESIDENT)
- **Authorized official phone:** (217) 362-6226

## Contact information

- **Practice address:** 890 E RIDGELAWN RD, MARTINSVILLE, IL 62442-2551
- **Practice address phone:** (217) 382-4004
- **Practice address fax:** (217) 382-3476
- **Mailing address:** 2245 W MOUND RD, DECATUR, IL 62526-9367
- **Mailing address phone:** (217) 362-6226
- **Mailing address fax:** (217) 362-6241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054020327 | IL | Yes |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 06/02/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2136610 | PK | — |