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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