Organization
MOORE GENUINE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE MOORE (MEMBER)
(715) 286-2734
Entity
Organization
Contact information
Practice address
711 ANDERSON ST, AUGUSTA, WI 54722-9002
(715) 286-2734
(715) 286-2736
Mailing address
711 ANDERSON ST, LOWER LEVEL, AUGUSTA, WI 54722-9002
(715) 286-2734
(715) 286-2736
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43114200
—
WI
Enumeration date
05/23/2006
Last updated
08/22/2020
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