Organization
MOORE HEALTHCARE INC
Active
Other names
PALACE DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY MOORE DPH (MANAGER)
(918) 358-2587
Entity
Organization
Contact information
Practice address
301 N BROADWAY ST, CLEVELAND, OK 74020-3421
(918) 358-2524
(918) 358-2588
Mailing address
301 N BROADWAY ST, CLEVELAND, OK 74020-3421
(918) 358-2524
(918) 358-2588
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
524094
OK
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100811860A
—
OK
05
—
100811860B
—
OK
01
—
2081522
PK
—
Enumeration date
02/16/2007
Last updated
01/17/2017
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