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MD MOULTON LLC NPI 1336498377


NPI Information

NPI: 1336498377
Provider Name: MD MOULTON LLC

Doing Business As: MIKE'S PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
8400 ASTRONAUT BLVD
CAPE CANAVERAL, FL
ZIP 32920
Phone: (321) 783-7883
Get Directions

MD MOULTON LLC is a community/retail pharmacy pharmacy in Cape Canaveral, FL. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. MD MOULTON LLC NPI is 1336498377. The provider is registered as an organization entity type.
The provider Is Doing Business As Mike's Pharmacy.

The provider's business location address is:

8400 ASTRONAUT BLVD
CAPE CANAVERAL, FL
ZIP 32920-302
Phone: (321) 783-7883
Fax: (321) 783-7889

The provider's authorized official is Michael Moulton .
The authorized official title is Owner/pharmacist and has the following contact phone number (321) 783-7883.

The enumeration date for this NPI number is 9/6/2012 and was last updated on 2/12/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyPH26299FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1006742800MEDICAIDFLORIDA
25711660OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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