Nicholas Antonio Moore, DOCTOR OF PHARMACY
NPI 1265042691ActiveIndividual· Pharmacist· Fairview Heights, IL
Pharmacist (DOCTOR OF PHARMACY) in Fairview Heights, Illinois, licensed in MO and AZ, with an NPI issued in July 2020.
Overview
| NPI | 1265042691 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DOCTOR OF PHARMACY |
| Sole proprietor | Yes |
| NPI issued | Jul 31, 2020 |
| Last updated in NPPES | Jul 31, 2020 |
| Certified by provider | Jul 31, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist Primary | 183500000X | 2016027148 | MO |
| Pharmacist | 183500000X | S022386 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 23 pharmacists in Fairview Heights · All pharmacists in Illinois