Provider Demographics
NPI:1215279013
Name:MOCHIX
Entity type:Organization
Organization Name:MOCHIX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:COF
Authorized Official - Phone:573-234-2005
Mailing Address - Street 1:2601 MAGUIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8253
Mailing Address - Country:US
Mailing Address - Phone:573-234-2005
Mailing Address - Fax:573-234-2008
Practice Address - Street 1:2601 MAGUIRE BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8253
Practice Address - Country:US
Practice Address - Phone:573-234-2005
Practice Address - Fax:573-234-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO6964760001Medicare NSC