Provider Demographics
NPI:1962653626
Name:MOORE GLOBAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:MOORE GLOBAL SOLUTIONS LLC
Other - Org Name:BRIGHTSTAR HEALTHCARE MESA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-898-0880
Mailing Address - Street 1:1223 S CLEARVIEW AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-3306
Mailing Address - Country:US
Mailing Address - Phone:480-898-0880
Mailing Address - Fax:480-898-0990
Practice Address - Street 1:1223 S CLEARVIEW AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-3306
Practice Address - Country:US
Practice Address - Phone:480-898-0880
Practice Address - Fax:480-898-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ435110Medicaid
HCO 514546OtherJOINT COMMISSION