Provider Demographics
NPI:1164722526
Name:MORAN, JOSEPH VINCENT (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:VINCENT
Last Name:MORAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27152 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-8546
Mailing Address - Country:US
Mailing Address - Phone:303-838-7859
Mailing Address - Fax:
Practice Address - Street 1:27152 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONIFER
Practice Address - State:CO
Practice Address - Zip Code:80433-8546
Practice Address - Country:US
Practice Address - Phone:303-838-7859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist