Provider Demographics
NPI:1053396952
Name:H.E. MOSER CORPORATION
Entity type:Organization
Organization Name:H.E. MOSER CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:573-729-3300
Mailing Address - Street 1:900 S MAIN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MO
Mailing Address - Zip Code:65560
Mailing Address - Country:US
Mailing Address - Phone:573-729-3300
Mailing Address - Fax:573-729-9567
Practice Address - Street 1:900 S MAIN
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MO
Practice Address - Zip Code:65560
Practice Address - Country:US
Practice Address - Phone:573-729-3300
Practice Address - Fax:573-729-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO6290332B00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO628852709Medicaid
MO608852703Medicaid
1187560001Medicare NSC