Healthcare Provider Details

I. General information

NPI: 1285801712
Provider Name (Legal Business Name): THE MOXI CO., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 TAMIAMI TRL S
VENICE FL
34293-5130
US

IV. Provider business mailing address

18010 SILVER PKWY
FENTON MI
48430-3421
US

V. Phone/Fax

Practice location:
  • Phone: 941-492-3600
  • Fax: 941-492-3622
Mailing address:
  • Phone: 810-750-2626
  • Fax: 810-750-2772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number3501000547
License Number StateMI

VIII. Authorized Official

Name: MR. DAVID ALAN MAHAN
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 810-750-2626