MEDICARE: YOLANDA MOORE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker		MI

General Provider Information

NPI Number	:	1245193846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA MOORE

Provider Business Mailing Address
First Line	:	20131 JAMES COUZENS FWY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-1890
Country	:	US
Telephone Number	:	313-558-8499
Fax Number	:

Provider Business Practice Location Address
First Line	:	20131 JAMES COUZENS FWY
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-1890
Country	:	US
Telephone Number	:	313-558-8499
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

Similar Medicare Providers

1356123285 — YOVA LLC
Practice Location Address:

20131 JAMES COUZENS FWY
DETROIT, MI
48235-1890

Practice Phone: 313-850-9837
Practice Fax:

1942082607 — CONVERSION CONTRACTING LLC
Practice Location Address:

20131 JAMES COUZENS FWY
DETROIT, MI
48235-1890

Practice Phone: 313-445-4765
Practice Fax:

1619749801 — CONVERSION CONTRACTING LLC
Practice Location Address:

20131 JAMES COUZENS FWY
DETROIT, MI
48235-1890

Practice Phone: 313-558-8499
Practice Fax:

1841186871 — CONVERSION CONTRACTING LLC
Practice Location Address:

20131 JAMES COUZENS FWY
DETROIT, MI
48235-1890

Practice Phone: 313-558-8499
Practice Fax:

1295728095 — KNIGHT PRESCRIPTION SERVICES
Practice Location Address:

4501 WOODWARD AVE , SUITE 104A
DETROIT, MI
48201-1890

Practice Phone: 313-832-5800
Practice Fax: 313-832-5802

1154610558 — STATE PHARMACY
Practice Location Address:

4501 WOODWARD AVE STE 104A
DETROIT, MI
48201-1890

Practice Phone: 313-832-4970
Practice Fax:

Directions to “ YOLANDA MOORE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.