Organization
MOBY RX
Active
Other names
Moby Rx
Organization subpart
No
Provider details
NPI number
Authorized official
MOMENJAN ABDULLAYOF (PRESIDENT/OWNER)
(207) 899-4600
Entity
Organization
Contact information
Practice address
225 WATERMAN DR, SOUTH PORTLAND, ME 04106-3634
(207) 899-4600
(207) 899-4613
Mailing address
225 WATERMAN DR, SOUTH PORTLAND, ME 04106-3634
(207) 899-4600
(207) 899-4613
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH50001426
ME
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2130568
PK
—
Enumeration date
04/19/2011
Last updated
01/13/2016
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