Organization
COMMUNITY VISION CENTER MOSSCO INC DR RANDY WAYNE MOSS OD
Active
Other names
Community Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY WAYNE MOSS OD (OPTOMETRIST OWNER)
(870) 246-6877
Entity
Organization
Contact information
Practice address
109 WP MALONE, ARKADELPHIA, AR 71923
(870) 246-6877
(870) 245-0088
Mailing address
109 WP MALONE, ARKADELPHIA, AR 71923
(870) 246-6877
(870) 245-0088
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2140
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48222
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/16/2006
Last updated
12/27/2007
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