Healthcare Provider Details

I. General information

NPI: 1477112100
Provider Name (Legal Business Name): MOYOCK INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 OXFORD RD
MOYOCK NC
27958-8763
US

IV. Provider business mailing address

246 OXFORD RD
MOYOCK NC
27958-8763
US

V. Phone/Fax

Practice location:
  • Phone: 252-285-6898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: CORY ARNOLD
Title or Position: DIRECTOR
Credential:
Phone: 757-286-8030