Healthcare Provider Details

I. General information

NPI: 1821492729
Provider Name (Legal Business Name): MOORE HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2014
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S MAIN ST
EMPORIA VA
23847-2314
US

IV. Provider business mailing address

PO BOX 111
EMPORIA VA
23847-0111
US

V. Phone/Fax

Practice location:
  • Phone: 434-348-8861
  • Fax: 434-348-0661
Mailing address:
  • Phone: 434-348-8861
  • Fax: 434-348-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-13757
License Number StateVI

VIII. Authorized Official

Name: SUE A MOORE
Title or Position: ADMINISTRATOR
Credential:
Phone: 434-348-8861