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General NPI Number Information
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NPI Number | 1699804757
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Entity Type | Organization
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Legal Business Name | MOSS HEARING AIDS, INCORPORATED
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 114 N 6TH ST
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City | QUINCY
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State | IL
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Zip | 62301-2904
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Country | US
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Telephone | 217-223-0204
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Fax | 217-223-0274
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Provider Business Mailing Address
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Address Line | 114 N 6TH ST
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City | QUINCY
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State | IL
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Zip | 62301-2904
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Country | US
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Telephone | 217-223-0204
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Fax | 217-223-0274
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT J MOSS
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Credential | AU.D.
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Telephone | 217-223-0204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147000603
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 147000603
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 147000603
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License Number State | IL
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