Provider Demographics
NPI:1043731250
Name:MOORE, DAWN MARIE (PHARM D)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:MOORE
Suffix:
Gender:F
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 1:10489 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16438-7951
Mailing Address - Country:US
Mailing Address - Phone:814-657-7433
Mailing Address - Fax:
Practice Address - Street 1:5515 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2603
Practice Address - Country:US
Practice Address - Phone:814-657-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist