Provider Demographics
NPI:1225609431
Name:MOSES, CARLEY TAYLOR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARLEY
Middle Name:TAYLOR
Last Name:MOSES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:719 E OCEAN VIEW AVE APT 312
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-1782
Mailing Address - Country:US
Mailing Address - Phone:804-896-1858
Mailing Address - Fax:
Practice Address - Street 1:1446 CHURCH ST STE C
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-2448
Practice Address - Country:US
Practice Address - Phone:757-227-4677
Practice Address - Fax:757-961-4083
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022197041835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist