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Organization

EDWIN B MOSS

Active
Other names
MOSS EYECARE CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWIN BURNETT MOSS O.D. (OPTOMETRIST)
(318) 539-5905
Entity
Organization

Contact information

Practice address
207 E CHURCH ST, SPRINGHILL, LA 71075-3303
(318) 539-5905
(318) 539-5908
Mailing address
207 E CHURCH ST, SPRINGHILL, LA 71075-3303
(318) 539-5905
(318) 539-5908

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
918096T
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1316620002
DMERC
LA
05
1363871
LA
Enumeration date
11/02/2006
Last updated
06/03/2008
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