Provider Demographics
NPI:1043366420
Name:MOORE DRUGS INC
Entity Type:Organization
Organization Name:MOORE DRUGS INC
Other - Org Name:PHYLLIS MOORE MCCAIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-667-7411
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:510 MAIN ST
Mailing Address - City:HURTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:36860
Mailing Address - Country:US
Mailing Address - Phone:334-667-7411
Mailing Address - Fax:334-667-7411
Practice Address - Street 1:510 MAIN ST
Practice Address - Street 2:
Practice Address - City:HURTSBORO
Practice Address - State:AL
Practice Address - Zip Code:36860
Practice Address - Country:US
Practice Address - Phone:334-667-7411
Practice Address - Fax:334-667-7411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9699333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
O124898Medicare UPIN