Provider Demographics
NPI:1821287996
Name:MOATS, STELLA MARIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:STELLA
Middle Name:MARIE
Last Name:MOATS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 UNIVERSITY TOWN CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-2264
Mailing Address - Country:US
Mailing Address - Phone:304-599-2369
Mailing Address - Fax:304-599-2520
Practice Address - Street 1:4500 UNIVERSITY TOWN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-2264
Practice Address - Country:US
Practice Address - Phone:304-599-2369
Practice Address - Fax:304-599-2520
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist