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Deactivated NPI 1295894145 Deactivated / Inactive NPI Male Practitioner

Vincent D Moore , RPH

Pharmacist • Wadena, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Vincent Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 07, 2006
NPI Deactivation Date November 08, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Vincent Moore, RPH was a registered Pharmacist practicing in Wadena, MN. Throughout an active medical career spanning 18 years, Vincent Moore provided care at the practice location at 321 JEFFERSON ST N until profile deactivation on 2024-11-08.

Practice Location & Contact Primary Location

Practice Address

321 Jefferson St N

Wadena, MN 564821372

Telephone 2186314050
Fax 2186312726
Associated Practice Facility / Clinic
🏢 Schwartzwald Drug Inc. Facility NPI 1770594558

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Wadena, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
29 Specialists

Practicing in Wadena, MN (4994 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License MN 110091-2

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Kaylee Poppen

Pharmacist

NPI 1043130735
NPI 1134295967

Doctor of Pharmacy (Pharm.D.), Registered Pharmacist

NPI 1174299259

Doctor of Pharmacy (Pharm.D.)

Tori Mcdougald

Pharmacist

NPI 1346125978
Kammy Larson

Pharmacist

NPI 1417329582
NPI 1437644275

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 08, 2024

Record deactivated on November 08, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 321 JEFFERSON ST N, WADENA, MN 564821372 (Tel: 2186314050)

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Updated Business Mailing Address July 08, 2007

Registered at 181 PARKVIEW AVE, WADENA, MN 564822407 (Tel: 2186314050)

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Provider Name / Credentials Updated July 08, 2007

Recorded as VINCENT MOORE, R.PH.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pharmacist (License #110091-2 in MN)

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Initial NPI Registration & Enumeration December 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1295894145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 07, 2006
Last Update: July 08, 2007
Deactivation Date: November 08, 2024

Mailing Address

181 Parkview Ave

Wadena, MN 564822407

Phone: 2186314050

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.