Individual
GARY MORONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
19016 FORT ST, RIVERVIEW, MI 48193-6701
(734) 479-2010
Mailing address
19016 FORT ST, RIVERVIEW, MI 48193-6701
(734) 479-2010
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
03132359
OH
183500000X
Pharmacist
Primary
5302039792
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302039792
STATE OF MICHIGAN
MI
Enumeration date
11/09/2013
Last updated
11/09/2013
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