Individual
KATHERINE RUTH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 SOUTH US HIGHWAY 64, MANTEO, NC 27954
(252) 473-5056
(252) 473-6430
Mailing address
PO BOX 1877, MANTEO, NC 27954-1877
(252) 473-5056
(252) 473-6430
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16101
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0285114
—
NC
Enumeration date
10/16/2013
Last updated
10/16/2013
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