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NPI Code Detail

MEDICARE: MOORE LIFE ENTERPRISES INC

MEDICARE: MOORE LIFE ENTERPRISES INC
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
1208M00000XHospitalist Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609869247
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOORE LIFE ENTERPRISES INC
Provider Business Mailing Address
First Line : 916 QUAIL VALLEY DR
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-5806
Country : US
Telephone Number : 615-364-4158
Fax Number : 615-837-3445
Provider Business Practice Location Address
First Line : 1412 COUNTY HOSPITAL RD
Second Line :
City : NASHVILLE
State : TN
Zip : 37218-3007
Country : US
Telephone Number : 615-364-4158
Fax Number : 615-837-3445
Authorized Official
Title or Position : PRESIDENT
Name : WAYNE E MOORE
Credential : MD
Telephone Number : 615-837-3445
Provider Enumeration Date : 08/30/2005
Last Update Date : 08/22/2020

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Directions to “MOORE LIFE ENTERPRISES INC ” Practice Location

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