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Contact Information

DALE J MOSER
1520 N MCEWAN ST
CLARE, MI48617
 Phone: 989-386-2020
 Fax: 989-386-7308
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for DALE J MOSER

NPI # 1053615708
LBN Legal business name DALE J MOSER
Authorized official DALE MOSER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/10/2011
Last updated 04/03/2012 - About 14 years ago
Identifiers
MI License # 003085
MI License # 004640
MI License # 4901003085
MI Medicaid 1769910
MI Medicaid 1908862
MI Other 900A86500 BLUE CROSS BLUE SHIED
MI Other 0A86500 MEDICARE ID-INSPECIFIED
MI Other 410008233 RAIL ROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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