Healthcare Provider Details
I. General information
NPI: 1679029821
Provider Name (Legal Business Name): MOSLEY GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7208 CHESTNUT AVE 1
MELROSE PARK PA
19027
US
IV. Provider business mailing address
7208 CHESTNUT AVE FIRST FLOOR
MELROSE PARK PA
19027
UM
V. Phone/Fax
- Phone: 215-588-4425
- Fax: 215-635-1345
- Phone: 267-307-8765
- Fax: 215-331-2000
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 31853601 |
| License Number State | PA |
VIII. Authorized Official
Name: MS.
NOEL
C
MOSLEY
Title or Position: OWNER/OPERATOR
Credential: PRESIDENT
Phone: 267-307-8765