Provider Demographics
NPI:1033456850
Name:MORIEARTY, CODY (PHARM D)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:MORIEARTY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 HILLDALE WAY
Mailing Address - Street 2:T-2765
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2644
Mailing Address - Country:US
Mailing Address - Phone:608-807-3979
Mailing Address - Fax:
Practice Address - Street 1:451 JUNCTION RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-2656
Practice Address - Country:US
Practice Address - Phone:608-265-7070
Practice Address - Fax:608-265-7456
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16345-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist