Organization Name: | JOHN R MOSS & ARCHIE P GILLIAM PTR |
NPI Number: | 1912069790 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN MOSS (OWNER) |
Mailing Address: | 102 S Mcgee St Borger |
State: | TX US |
Postal Code: | 790074020 |
Phone Number: | 8062735606 |
Fax Number: | 8062733272 |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 06/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |