Provider Demographics
NPI:1659544963
Name:MOORE, JAMES O (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:O
Last Name:MOORE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:2630 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-4238
Mailing Address - Country:US
Mailing Address - Phone:252-514-0374
Mailing Address - Fax:252-514-2324
Practice Address - Street 1:2630 DR MLK JR BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562
Practice Address - Country:US
Practice Address - Phone:252-514-0374
Practice Address - Fax:252-514-2324
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist