Provider Demographics
NPI:1932793536
Name:MOYE, COREY ALEXANDER
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:ALEXANDER
Last Name:MOYE
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 1:288 BOWDEN LANE, , ATHENS
Mailing Address - Street 2:
Mailing Address - City:UNITED STATES
Mailing Address - State:GA
Mailing Address - Zip Code:30606
Mailing Address - Country:US
Mailing Address - Phone:706-352-7857
Mailing Address - Fax:
Practice Address - Street 1:288 BOWDEN LANE, , ATHENS
Practice Address - Street 2:
Practice Address - City:UNITED STATES
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-352-7857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)