Provider Demographics
NPI:1457500845
Name:MOXEY, ERNEST RAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:RAY
Last Name:MOXEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-4211
Mailing Address - Country:US
Mailing Address - Phone:573-471-7048
Mailing Address - Fax:573-481-2806
Practice Address - Street 1:299 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-4211
Practice Address - Country:US
Practice Address - Phone:573-471-7048
Practice Address - Fax:573-481-2806
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO029961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist