Organization
MOFFETTRX LLC
Active
Other names
Ole Towne Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ANDREW MOFFETT PHARMD (PHARMACIST IN CHARGE/OWNER)
(601) 693-0033
Entity
Organization
Contact information
Practice address
2000 24TH AVE, MERIDIAN, MS 39301-3120
(601) 693-0033
(601) 693-0062
Mailing address
2000 24TH AVE, MERIDIAN, MS 39301-3120
(601) 693-0033
(601) 693-0062
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03424-01MM
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330246
—
MS
01
—
2518629
NABP
—
Enumeration date
06/02/2005
Last updated
04/27/2022
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