Organization
MOORES PHARMACY INC
Active
Organization
MOORES PHARMACY INC
Active
Other names
MOORES COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KELBY DAIN GORMAN R.PH. (PRESIDENT)
(361) 853-2061
Entity
Organization
Contact information
Practice address
5945 MCARDLE RD STE 101, CORPUS CHRISTI, TX 78412-3491
(361) 853-2061
(361) 853-2055
Mailing address
5945 MCARDLE RD, STE 101, CORPUS CHRISTI, TX 78412-3490
(361) 853-2061
(361) 853-2055
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23216
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4537025
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/13/2006
Last updated
11/07/2022
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