Organization
YOUR SENIOR STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL R. MOOSO (PRESIDENT)
(970) 352-2440
Entity
Organization
Contact information
Practice address
1990 GREELEY MALL, GREELEY, CO 80631-8520
(970) 352-2440
Mailing address
1990 GREELEY MALL, GREELEY, CO 80631-8520
(970) 352-2440
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41387571
—
CO
Enumeration date
08/08/2006
Last updated
07/21/2022
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