Healthcare Provider Details

I. General information

NPI: 1578000642
Provider Name (Legal Business Name): MOORE PLUMBING & HOME IMPROVEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3830 HIGGINS ST
LOVELAND CO
80538-4960
US

IV. Provider business mailing address

3830 HIGGINS ST
LOVELAND CO
80538-4960
US

V. Phone/Fax

Practice location:
  • Phone: 970-219-6822
  • Fax: 970-682-6494
Mailing address:
  • Phone: 970-219-6822
  • Fax: 970-682-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberMP00179558
License Number StateCO

VIII. Authorized Official

Name: JOHN JAMES MOORE
Title or Position: PRESIDENT
Credential: MASTER PLUMBER
Phone: 970-219-6823