Provider Demographics
NPI:1861854036
Name:MOORE, MELISSA CLONINGER (PHARMD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CLONINGER
Last Name:MOORE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2363
Mailing Address - Country:US
Mailing Address - Phone:910-692-5171
Mailing Address - Fax:
Practice Address - Street 1:250 TURNER ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2363
Practice Address - Country:US
Practice Address - Phone:910-692-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist