Provider Demographics
NPI:1376900761
Name:MOORE RX, LLC
Entity Type:Organization
Organization Name:MOORE RX, LLC
Other - Org Name:MOORE RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCDOWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:405-735-5101
Mailing Address - Street 1:2018 I-35 SERVICE RD S.
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160
Mailing Address - Country:US
Mailing Address - Phone:405-735-5101
Mailing Address - Fax:405-735-9523
Practice Address - Street 1:2018 S SERVICE RD # I-35
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5512
Practice Address - Country:US
Practice Address - Phone:405-735-5101
Practice Address - Fax:405-735-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy