Provider Demographics
NPI:1992736532
Name:MOSSLANDER, RITA MARIE (PCA)
Entity type:Individual
Prefix:
First Name:RITA
Middle Name:MARIE
Last Name:MOSSLANDER
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TRABAR DR
Mailing Address - Street 2:APT. 11
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1048
Mailing Address - Country:US
Mailing Address - Phone:740-695-4168
Mailing Address - Fax:
Practice Address - Street 1:700 TRABAR DR
Practice Address - Street 2:APT. 11
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1048
Practice Address - Country:US
Practice Address - Phone:740-695-4168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2267176Medicaid