Provider Demographics
NPI:1497847412
Name:MOYER, MICHAEL GRANT (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:GRANT
Last Name:MOYER
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 1:1528 THOMPSON LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6732
Mailing Address - Country:US
Mailing Address - Phone:717-795-0163
Mailing Address - Fax:
Practice Address - Street 1:701 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1624
Practice Address - Country:US
Practice Address - Phone:717-774-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044283L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist