Provider Demographics
NPI:1851113633
Name:MOSLEY HEALTHCARE SERVICE LLC
Entity type:Organization
Organization Name:MOSLEY HEALTHCARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE HR OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAHAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-756-1513
Mailing Address - Street 1:105 VULCAN RD STE 211
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4701
Mailing Address - Country:US
Mailing Address - Phone:205-756-1513
Mailing Address - Fax:
Practice Address - Street 1:3004 MCGOUGH CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605-4026
Practice Address - Country:US
Practice Address - Phone:205-756-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty