Healthcare Provider Details

I. General information

NPI: 1053396952
Provider Name (Legal Business Name): H.E. MOSER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S MAIN
SALEM MO
65560
US

IV. Provider business mailing address

900 S MAIN
SALEM MO
65560
US

V. Phone/Fax

Practice location:
  • Phone: 573-729-3300
  • Fax: 573-729-9567
Mailing address:
  • Phone: 573-729-3300
  • Fax: 573-729-9567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number6290
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number6290
License Number StateMO

VIII. Authorized Official

Name: JULIA D MOSER
Title or Position: SECRETARY OWNER
Credential: RPH
Phone: 573-729-3300