Provider Demographics
NPI:1750676136
Name:MOORE CORPORATE ENTERPRISES
Entity Type:Organization
Organization Name:MOORE CORPORATE ENTERPRISES
Other - Org Name:MCDONALD HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-218-4100
Mailing Address - Street 1:2281 LAVA RIDGE CT
Mailing Address - Street 2:STE. 130
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2801
Mailing Address - Country:US
Mailing Address - Phone:916-218-4100
Mailing Address - Fax:916-218-4101
Practice Address - Street 1:2281 LAVA RIDGE CT
Practice Address - Street 2:STE. 130
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2801
Practice Address - Country:US
Practice Address - Phone:916-218-4100
Practice Address - Fax:916-218-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment