Provider Demographics
NPI:1023325768
Name:TROMPETER, MOSS (RPH)
Entity type:Individual
Prefix:
First Name:MOSS
Middle Name:
Last Name:TROMPETER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1931 CAM FELLA ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123
Mailing Address - Country:US
Mailing Address - Phone:714-679-2548
Mailing Address - Fax:
Practice Address - Street 1:1931 CAM FELLA ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123
Practice Address - Country:US
Practice Address - Phone:714-679-2548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00004413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist