Individual
MR. CHARLES LEON MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
2029 N LINCOLN AVE, YORK, NE 68467-1025
(402) 362-4429
(402) 362-4980
Mailing address
124 S DELAWARE AVE, YORK, NE 68467-3902
(402) 362-6499
(402) 362-4980
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8476
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8476
STATE PHARMACY LICENSE
NE
Enumeration date
07/25/2006
Last updated
07/08/2007
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