DR. MALLORY LOU MOORE (NPI# 1326694167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326694167 |
| Entity Type | Individual |
| Full Name | DR. MALLORY LOU MOORE |
| Credential | PHARMD |
| Practice Address |
3614 Providence Rd S Ste 200 Waxhaw NC 28173-6310 |
| Mailing Address |
900 E Stonewall St Apt 513 Charlotte NC 28204-3084 |
| Practice Telephone | 7043848640 |
| Mailing Telephone | 9193022434 |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2020-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
41513 | TN | Pharmacy Service Providers |
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
27693 | NC | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084398 | Mallory Moore | Behavioral Analyst | 102 Mary Alice Park Rd Ste 304, Cumming, GA 30040-2683 | 2020-08-24 |
| 1578972501 | Mallory Moore | Licensed Practical Nurse | 5252 Refugee Rd, Columbus, OH 43232-5355 | 2014-08-04 |
| 1336580950 | Mallory Nicole Moore | Speech-Language Pathologist | 101 Chapman Hill Rd Ste 101, Clemson, SC 29631-2194 | 2013-07-11 |
| 1306474796 | Mallory Moore | Speech-Language Pathologist | 3535 S National Ave, Springfield, MO 65807-7310 | 2020-03-31 |
| 1427690833 | Mallory L Moore | Behavior Technician | 27777 Inkster Rd, Farmington Hills, MI 48334-5326 | 2019-10-17 |
| 1972152197 | Mallory Moore | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd, Greenville, NC 27834-4300 | 2019-09-10 |
| 1649824236 | Mallory Moore | Speech-Language Pathologist | 2309 S Service Rd W, Ruston, LA 71270-3167 | 2019-07-31 |
| 1265085807 | Mallory Moore | Physical Therapist | 1700 N Division St Ste 200, Davenport, IA 52804-3535 | 2019-07-23 |
| 1396146403 | Mallory Moore | Physical Therapist | 100 Crofton Pl, Palmyra, VA 22963-3300 | 2014-09-08 |
| 1285058560 | Mallory Moore | Social Worker | 109 S 2nd St, Central City, KY 42330-1505 | 2014-02-07 |
| Street Address |
3614 PROVIDENCE RD S STE 200 |
| City | WAXHAW |
| State | NC |
| Zip Code | 28173-6310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134181118 | Howard M Guthmann II | Family Medicine | 3614 Providence Rd S Ste 200, Waxhaw, NC 28173-7394 | 2006-04-05 |
| 1689028664 | Adam Renard Culver | Family Medicine | 3614 Providence Rd S Ste 200, Waxhaw, NC 28173-6310 | 2016-04-15 |
| 1871982157 | Lisa Marie Rutherford | Nurse Practitioner | 3614 Providence Rd S Ste 200, Waxhaw, NC 28173-6310 | 2015-01-09 |
| 1407132178 | Jennifer Lynn Gonzales | Physician Assistant | 3614 Providence Rd S Ste 200, Waxhaw, NC 28173-6310 | 2011-10-26 |
| 1144310624 | David Perry Smith | Family Medicine | 3614 Providence Rd S Ste 200, Waxhaw, NC 28173 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733175 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1615 Providence Road South, Marvin, NC 28173 | 2020-06-04 |
| 1225507320 | Shane Markey Dds Ms Pllc | Dentist | 8412 New Town Rd Ste A, Waxhaw, NC 28173 | 2018-11-19 |
| 1336631514 | Suganya Nelatoor,d.d.s.,p.l.l.c. | Clinic/Center | 102 E Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2018-06-04 |
| 1184120750 | Restore Healthcare Medical Group | Counselor | 500 Waxhaw Professional Park Drive, Ste 105 F, Waxhaw, NC 28173 | 2018-04-03 |
| 1730690827 | Concrete Roses Consulting | Community/Behavioral Health | 5960 Fairview Road, 323, Charlotte, NC 28173 | 2017-10-17 |
| 1861849523 | Kayla Selena Caldwell | Social Worker | 3908 Rev. H. Morrison Rd., Waxhaw, NC 28173 | 2016-05-23 |
| 1588023782 | Teri Hipp | Counselor | 101-e Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2016-02-16 |
| 1710355508 | Caresmatic Phase 1,inc. | Assisted Living Facility | 520 Pembroke Ln., Waxhaw, NC 28173 | 2015-09-10 |
| 1437564838 | Anna Waddell Schneiderman | Counselor | 104 Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2014-06-24 |
| 1467892109 | Samantha Weidele Waldman | Counselor | 9929 Rea Rd Ste 201, Waxhaw, NC 28173 | 2013-06-26 |
| Find all providers in zip 28173 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033679790 | Asajah Duncan | Pharmacist | 3769 Stafford Place Blvd Apt 302, Winston Salem, NC 27127-6930 | 2019-03-20 |
| 1164990990 | Christan Turner Holt | Pharmacist | 1225 Huffman Mill Rd Ste 102, Burlington, NC 27215-8789 | 2018-11-09 |
| 1215420955 | Maeghan Nichole Moss | Pharmacist | 100 Medical Park Dr Ste 110, Concord, NC 28025-2966 | 2018-06-07 |
| 1275086522 | Autumn Carroll | Pharmacist | 1 Hospital Dr Ste 3217, Asheville, NC 28801-4550 | 2016-08-03 |
| 1720439938 | Christine Williams | Pharmacist | 110 Heather Ridge Ct, Durham, NC 27712-1067 | 2016-06-29 |
| 1699124479 | Chelsea Elaine Phillips Renfro | Pharmacist | 2011 Summerhouse Rd, Cary, NC 27519-7453 | 2016-06-12 |
| 1316394471 | Daniel Wolverton | Pharmacist | 1025 Think Pl Ste 460, Morrisville, NC 27560 | 2016-05-18 |
| 1801131107 | Ann Marie Fugit | Pharmacist | 2470 Stantonsburg Rd, Greenville, NC 27834-7210 | 2012-11-28 |
| 1942552716 | Lydia Wang | Pharmacist | 4400 Golf Acres Dr Ste C, Charlotte, NC 28208-5976 | 2012-10-03 |
| 1588645030 | Deborah Sturpe | Pharmacist | 590 Manning Dr, Chapel Hill, NC 27599-6119 | 2005-11-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.