Provider Demographics
NPI:1023382702
Name:MOYSE, JOHN WILLIAM (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLIAM
Last Name:MOYSE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 HIGHLAND RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2275
Mailing Address - Country:US
Mailing Address - Phone:330-405-7040
Mailing Address - Fax:330-405-7044
Practice Address - Street 1:1750 HIGHLAND RD
Practice Address - Street 2:SUITE 7
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2275
Practice Address - Country:US
Practice Address - Phone:330-405-7040
Practice Address - Fax:330-405-7044
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH030117365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist