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NPI 1730090671

NPI 1730090671 : MOXIE MEDICAL SUPPLY : MOUNTAIN GREEN, UT

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General NPI Number Information
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    NPI Number           |    1730090671
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    Entity Type          |    Organization 
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    Legal Business Name  |    MOXIE MEDICAL SUPPLY 
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Dates
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    Enumeration Date     |    09/16/2026
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    Last Update Date     |    09/16/2026
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Provider Practice Location Address
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    Address Line         |    5991 N MESA ARCH LN 
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    City                 |    MOUNTAIN GREEN
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    State                |    UT
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    Zip                  |    84050-6002
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    Country              |    US
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    Telephone            |    801-876-0871
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5780 SILVERSTONE CIR 
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    City                 |    MOUNTAIN GREEN
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    State                |    UT
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    Zip                  |    84050-9723
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    Country              |    US
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    Telephone            |    801-876-0871
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     NATHANIEL  STEPHENS 
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    Credential           |    
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    Telephone            |    801-876-0871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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