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Organization
MOORE FAMILY STORES INC.
Active
Organization
MOORE FAMILY STORES INC.
Active
Other names
Browns Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT MOORE (OWNER/PRESIDENT)
(217) 362-6226
Entity
Organization
Contact information
Practice address
115 W JEFFERSON AVE, EFFINGHAM, IL 62401-2344
(217) 342-2185
(217) 342-7069
Mailing address
115 W JEFFERSON AVE, EFFINGHAM, IL 62401-2344
(217) 342-2185
(217) 342-7069
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054020328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054016709
STATE PHARMACY LICENSE
IL
01
—
1386717502
NPI
—
01
—
1463708
NCPDP
—
01
—
16103882
STATE TAX ID
IL
Enumeration date
11/16/2006
Last updated
03/07/2023
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