Provider Demographics
NPI:1346511888
Name:MOORE, VALERIE MORGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:MORGAN
Last Name:MOORE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5071 KIPLING ST
Mailing Address - Street 2:TARGER PHARMACY STORE NUMBER (T-2021)
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2251
Mailing Address - Country:US
Mailing Address - Phone:303-209-1849
Mailing Address - Fax:303-209-1849
Practice Address - Street 1:5071 KIPLING ST
Practice Address - Street 2:TARGER PHARMACY STORE NUMBER (T-2021)
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2251
Practice Address - Country:US
Practice Address - Phone:303-209-1849
Practice Address - Fax:303-209-1849
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist