Provider Demographics
NPI:1265249536
Name:MOSLEY, GLADYS
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 LOVE TOWN RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO JUNCTION
Mailing Address - State:VA
Mailing Address - Zip Code:24529-2906
Mailing Address - Country:US
Mailing Address - Phone:804-631-3312
Mailing Address - Fax:
Practice Address - Street 1:1565 LOVE TOWN RD
Practice Address - Street 2:
Practice Address - City:BUFFALO JUNCTION
Practice Address - State:VA
Practice Address - Zip Code:24529-2906
Practice Address - Country:US
Practice Address - Phone:804-631-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)