Provider Demographics
NPI:1164833182
Name:MOREAU, AUBREY JOSEPH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUBREY
Middle Name:JOSEPH
Last Name:MOREAU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5810
Mailing Address - Country:US
Mailing Address - Phone:904-343-6557
Mailing Address - Fax:
Practice Address - Street 1:14014 CONNETICUIT AVE
Practice Address - Street 2:KMART PHARMACY 4399
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905
Practice Address - Country:US
Practice Address - Phone:301-460-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist