Provider Demographics
NPI:1912048091
Name:MORAN, TODD BARRET (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:BARRET
Last Name:MORAN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 S 153RD CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2829
Mailing Address - Country:US
Mailing Address - Phone:402-598-7089
Mailing Address - Fax:
Practice Address - Street 1:13220 BIRCH DR STE 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-5434
Practice Address - Country:US
Practice Address - Phone:778-484-3798
Practice Address - Fax:515-559-2442
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist