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Organization
MOODYCARE INC.
Active
Organization
MOODYCARE INC.
Active
Other names
Coliseum Park Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BENJAMIN MOODY III RPH (PRESIDENT)
(478) 745-5431
Entity
Organization
Contact information
Practice address
380 HOSPITAL DR., STE 175-A, MACON, GA 31217
(478) 745-5431
(478) 765-4359
Mailing address
380 HOSPITAL DR., STE 175-A, MACON, GA 31217
(478) 745-5431
(478) 765-4359
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE004996
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122376
NCPDP OR NABP NUMBER
—
Enumeration date
03/15/2006
Last updated
08/22/2020
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