Healthcare Provider Details

I. General information

NPI: 1417629320
Provider Name (Legal Business Name): MOSS CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 E VIRGINIA AVE UNIT 7-303
DENVER CO
80247-1356
US

IV. Provider business mailing address

10150 E VIRGINIA AVE UNIT 7-303
DENVER CO
80247-1356
US

V. Phone/Fax

Practice location:
  • Phone: 720-641-6179
  • Fax: 720-302-2588
Mailing address:
  • Phone: 720-641-6179
  • Fax: 720-302-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: TAWANDA MOSS
Title or Position: OWNER/ MOBILE PHLEBTOMIST
Credential: CPT/MA
Phone: 720-641-6179