# MOON'S PHARMACY LTC

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

## Provider details

- **NPI number:** 1922118769
- **Authorized official:** CATHERINE M. MARAMAN PHARMD (OWNER)
- **Authorized official phone:** (229) 382-3711

## Contact information

- **Practice address:** 711 2ND ST W, TIFTON, GA 31794-4201
- **Practice address phone:** (229) 256-0139
- **Practice address fax:** (229) 256-0140
- **Mailing address:** 717 B W 2ND ST, TIFTON, GA 31794
- **Mailing address phone:** (229) 382-3711
- **Mailing address fax:** (229) 387-7521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | PHRE008877 | GA | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 03/26/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00003855C | — | GA |
| 01 | — | 1152482 | NDCP | — |