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NPI Code Detail

MEDICARE: MRS. LOIS B MOORE CNA / CTS

MEDICARE:  MRS. LOIS B MOORE  CNA / CTS
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
1332BN1400XNursing Facility Supplies (DME)208269611IL

General Provider Information

NPI Number : 1316188493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LOIS B MOORE CNA / CTS
Provider Business Mailing Address
First Line : 5306 S HOYNE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-5543
Country : US
Telephone Number : 773-603-0644
Fax Number : 773-471-3222
Provider Business Practice Location Address
First Line : 5306 S HOYNE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-5543
Country : US
Telephone Number : 773-603-0644
Fax Number : 773-471-3222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2009
Last Update Date : 08/05/2009

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Directions to “ MRS. LOIS B MOORE CNA / CTS” Practice Location

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