Provider Demographics
NPI:1417629320
Name:MOSS CARE SERVICES, LLC
Entity Type:Organization
Organization Name:MOSS CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MOBILE PHLEBTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:TAWANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:CPT/MA
Authorized Official - Phone:720-641-6179
Mailing Address - Street 1:10150 E VIRGINIA AVE UNIT 7-303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1356
Mailing Address - Country:US
Mailing Address - Phone:720-641-6179
Mailing Address - Fax:720-302-2588
Practice Address - Street 1:10150 E VIRGINIA AVE UNIT 7-303
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-1356
Practice Address - Country:US
Practice Address - Phone:720-641-6179
Practice Address - Fax:720-302-2588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty