Individual
CHARLES S. MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
409 MULBERRY AVE, SELMER, TN 38375-2307
(731) 645-4423
Mailing address
11 COUNTY ROAD 676, CORINTH, MS 38834-7419
(662) 223-9015
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11120
TN
183500000X
Pharmacist
12812
AL
183500000X
Pharmacist
T08597
MS
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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