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NPI Code Detail

MEDICARE: MR. BRIAN RICHARD MOORE I

MEDICARE: MR. BRIAN RICHARD MOORE I
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
13747P1801XPersonal Care AttendantOH

General Provider Information

NPI Number : 1629923859
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN RICHARD MOORE I
Provider Business Mailing Address
First Line : 1955 GRANGE VIEW DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2031
Country : US
Telephone Number : 937-232-4037
Fax Number :
Provider Business Practice Location Address
First Line : 1955 GRANGE VIEW DR
Second Line :
City : BEAVERCREEK
State : OH
Zip : 45432-2031
Country : US
Telephone Number : 937-232-4037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “ MR. BRIAN RICHARD MOORE I ” Practice Location

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