Provider Demographics
NPI:1982988531
Name:MOSER, ROBERT LEROY JR (BSPHARM, RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEROY
Last Name:MOSER
Suffix:JR
Gender:M
Credentials:BSPHARM, RPH
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Mailing Address - Street 1:255 CHARLOIS BLVD
Mailing Address - Street 2:WINSTON SALEM HEALTH CARE PHARMACY
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1507
Mailing Address - Country:US
Mailing Address - Phone:336-718-1544
Mailing Address - Fax:336-718-1545
Practice Address - Street 1:255 CHARLOIS BLVD
Practice Address - Street 2:WINSTON SALEM HEALTH CARE PHARMACY
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1507
Practice Address - Country:US
Practice Address - Phone:336-718-1544
Practice Address - Fax:336-718-1545
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC06916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist