Organization
RODNEY L MOORE
Active
Other names
Moore's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT C MOORE PHARMD (PHARMACY OPERATIONS MANAGER)
(601) 706-5417
Entity
Organization
Contact information
Practice address
16831 HWY 21 S, SEBASTOPOL, MS 39359
(601) 625-7158
(601) 625-9480
Mailing address
PO BOX 289, SEBASTOPOL, MS 39359-0289
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02178
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030128
—
MS
01
—
2511473
NCPDP
MS
Enumeration date
05/07/2007
Last updated
10/08/2019
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