Provider Demographics
NPI:1225344138
Name:MOORE, DESIREE (RPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DESIREE
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 PINE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1588
Mailing Address - Country:US
Mailing Address - Phone:412-331-7080
Mailing Address - Fax:412-331-7181
Practice Address - Street 1:1770 PINE HOLLOW RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1588
Practice Address - Country:US
Practice Address - Phone:412-331-7080
Practice Address - Fax:412-331-7181
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist