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Organization
MOORE FAMILY STORES INC.
Active
Organization
MOORE FAMILY STORES INC.
Active
Other names
The Pharmacie Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT J MOORE (OWNER/PRESIDENT)
(217) 362-6226
Entity
Organization
Contact information
Practice address
1 STALEY AVE, CASEY, IL 62420-1458
(217) 932-4004
(217) 609-6065
Mailing address
2245 W MOUND RD, DECATUR, IL 62526-9367
(217) 362-6226
(217) 362-6241
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054020331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1430216
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/28/2005
Last updated
07/24/2025
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