Provider Demographics
NPI:1295442309
Name:CARHART, MOISES MARTIN (PASTORAL CARE AID)
Entity type:Individual
Prefix:MR
First Name:MOISES
Middle Name:MARTIN
Last Name:CARHART
Suffix:
Gender:M
Credentials:PASTORAL CARE AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E MAIN AVE APT 608
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4068
Mailing Address - Country:US
Mailing Address - Phone:701-204-5797
Mailing Address - Fax:
Practice Address - Street 1:420 E MAIN AVE APT 608
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4068
Practice Address - Country:US
Practice Address - Phone:701-204-5797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND3363983Medicaid
NDND4710003OtherPAYMENT PLAN OPTIONS FOR THOSE WHO ARE ABLE
NDND4710003Medicaid
ND2QF0-YH2-AM22OtherMEDICARE HEALTH INSURANCE