Provider Demographics
NPI:1154610756
Name:MOORE, ARTHUR JR (RPH)
Entity type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:
Last Name:MOORE
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 STALLINGS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-6946
Mailing Address - Country:US
Mailing Address - Phone:864-322-2813
Mailing Address - Fax:864-322-6613
Practice Address - Street 1:1335 STALLINGS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-6946
Practice Address - Country:US
Practice Address - Phone:864-322-2813
Practice Address - Fax:864-322-6613
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC008629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist