Provider Demographics
NPI:1538467360
Name:MOYER HOLDINGS LLC
Entity Type:Organization
Organization Name:MOYER HOLDINGS LLC
Other - Org Name:MOYER RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-358-0009
Mailing Address - Street 1:2940 W MAPLE LOOP DR
Mailing Address - Street 2:SUITE 304A
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-5661
Mailing Address - Country:US
Mailing Address - Phone:801-997-0532
Mailing Address - Fax:801-407-1676
Practice Address - Street 1:2940 W MAPLE LOOP DR
Practice Address - Street 2:SUITE 304A
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-5661
Practice Address - Country:US
Practice Address - Phone:801-997-0532
Practice Address - Fax:801-407-1676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7903034-1704333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4612001OtherNCPDP PROVIDER IDENTIFICATION NUMBER