Provider Demographics
NPI:1710231758
Name:MOYERS, ANDREW J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:J
Last Name:MOYERS
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 1:1600 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-5707
Mailing Address - Country:US
Mailing Address - Phone:423-629-4155
Mailing Address - Fax:423-622-4558
Practice Address - Street 1:1600 E 23RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-5707
Practice Address - Country:US
Practice Address - Phone:423-629-4155
Practice Address - Fax:423-622-4558
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10342183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN10342OtherTENNESSEE BOARD OF PHARMACY
KY011299OtherKENTUCKY BOARD OF PHARMACY