Provider Demographics
NPI:1558570465
Name:MOLOY, RICHARD EWART
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EWART
Last Name:MOLOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CONCORD HILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03263-3710
Mailing Address - Country:US
Mailing Address - Phone:603-435-6732
Mailing Address - Fax:
Practice Address - Street 1:891 ROUTE 16
Practice Address - Street 2:
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03864
Practice Address - Country:US
Practice Address - Phone:603-539-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHR0552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist