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NPI 1962590265

NPI 1962590265 : CHAD L MOSER PHARMACIST : SPENCER, IA

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General NPI Number Information
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    NPI Number           |    1962590265
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    Entity Type          |    Individual 
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    Provider Name        |    CHAD L MOSER PHARMACIST
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/11/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1314 17TH AVE W 
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    City                 |    SPENCER
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    State                |    IA
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    Zip                  |    51301-2739
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    Country              |    US
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    Telephone            |    712-262-2673
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    Fax                  |    712-262-5469
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Provider Business Mailing Address
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    Address Line         |    1314 17TH AVE W 
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    City                 |    SPENCER
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    State                |    IA
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    Zip                  |    51301-2739
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    Country              |    US
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    Telephone            |    712-262-2673
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    Fax                  |    712-262-5469
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    17860
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    License Number State |    IA
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