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MOSSER CORPORATION NPI 1669510509


NPI Information

NPI: 1669510509
Provider Name: MOSSER CORPORATION

Doing Business As: MOSSER'S SHOES

Classification: Contractor - 171W00000X
Entity Type: Organization
Address:
2460 WABASH AVE
SPRINGFIELD, IL
ZIP 62704
Phone: (217) 787-7022
Get Directions

MOSSER CORPORATION is a contractor in Springfield, IL. The provider is a person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). MOSSER CORPORATION NPI is 1669510509. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Mosser's Shoes.

The provider's business location address is:

2460 WABASH AVE
SPRINGFIELD, IL
ZIP 62704-201
Phone: (217) 787-7022
Fax: (217) 787-7067

The provider's authorized official is Chandra D Coffee .
The authorized official title is Management Services Coordinator and has the following contact phone number (217) 351-5022.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 8/1/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171W00000XContractor37681893ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11141800002MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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