Provider Demographics
NPI:1780272856
Name:MOSES, MADELINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:
Last Name:MOSES
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 1:1621 CHARLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-3339
Mailing Address - Country:US
Mailing Address - Phone:270-705-8636
Mailing Address - Fax:812-941-7303
Practice Address - Street 1:1621 CHARLESTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3339
Practice Address - Country:US
Practice Address - Phone:270-705-8636
Practice Address - Fax:812-941-7303
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26027283A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care