# RODNEY L MOORE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Moore's Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376633818
- **Authorized official:** MR. RODNEY L MOORE RPH (OWNER)
- **Authorized official phone:** (601) 625-7158

## Contact information

- **Practice address:** 103 CHADWICK AVE, WALNUT GROVE, MS 39189
- **Practice address phone:** (601) 253-2599
- **Practice address fax:** (601) 253-2182
- **Mailing address:** PO BOX 369, WALNUT GROVE, MS 39189-0369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 02381 | MS | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 01/30/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330046 | — | MS |
| 01 | — | 2517968 | NCPDP | MS |