Organization
STEVEN A MOORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE MOORE (OWNER)
(712) 336-0999
Entity
Organization
Contact information
Practice address
2308 ENTERPRISE AVE, SPIRIT LAKE, IA 51360-7188
(712) 336-0999
(712) 336-9222
Mailing address
2308 ENTERPRISE AVE, SPIRIT LAKE, IA 51360-7188
(712) 336-0999
(712) 336-9222
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0278085
—
IA
01
—
31401
BLUE CROSS BLUE SHIELD
IA
01
—
F242865
MIDLANDS CHOICE
IA
Enumeration date
07/08/2006
Last updated
08/06/2012
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