Provider Demographics
NPI:1679147102
Name:MORAN, JAMES M (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:MORAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 KRESGE DRIVE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001
Mailing Address - Country:US
Mailing Address - Phone:440-282-7651
Mailing Address - Fax:440-282-7663
Practice Address - Street 1:2201 KRESGE DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1243
Practice Address - Country:US
Practice Address - Phone:440-282-7651
Practice Address - Fax:440-282-7663
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03129366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist