Provider Demographics
NPI:1801886288
Name:MOSHIER, RAY
Entity type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:MOSHIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3005
Mailing Address - Country:US
Mailing Address - Phone:320-632-2397
Mailing Address - Fax:320-632-3261
Practice Address - Street 1:301 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3005
Practice Address - Country:US
Practice Address - Phone:320-632-2397
Practice Address - Fax:320-632-3261
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN114187-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist