Individual
DR. PHILIP BRETT MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DOCTOR OF PHARMACY
Contact information
Practice address
200 AMERICAN BLVD W, BLOOMINGTON, MN 55420-1120
(952) 888-6079
(952) 888-6095
Mailing address
863 23RD AVE SE, MINNEAPOLIS, MN 55414-2607
(814) 316-6898
(952) 888-6095
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
121058
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121058
STATE PHARMACY LICENSE
MN
Enumeration date
01/24/2019
Last updated
01/24/2019
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