Provider Demographics
NPI:1457633349
Name:MOSLEY, ELMER LOUIS (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:ELMER
Middle Name:LOUIS
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6646 AUDUBON TRCE W
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-3001
Mailing Address - Country:US
Mailing Address - Phone:561-309-6881
Mailing Address - Fax:
Practice Address - Street 1:6646 AUDUBON TRCE W
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-3001
Practice Address - Country:US
Practice Address - Phone:561-309-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPS138021835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist