Provider Demographics
NPI:1538988985
Name:MOSER, LYVIA MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LYVIA
Middle Name:MARIE
Last Name:MOSER
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 1:801 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-1916
Mailing Address - Country:US
Mailing Address - Phone:218-233-1529
Mailing Address - Fax:218-233-8917
Practice Address - Street 1:801 CENTER AVE
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-1916
Practice Address - Country:US
Practice Address - Phone:218-233-1529
Practice Address - Fax:218-233-8917
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6596183500000X
MN126588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist