Moore Health Care T/a Senior Citizens Village

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HAL-043-006 Issued in NC

Legal business name

MOORE HEALTH CARE T/A SENIOR CITIZENS VILLAGE

Practice address

504 Canal Dr
Dunn, NC 28334-2323

Phone

(910) 892-1241

Fax

(910) 892-5549

NPI assigned

Jul 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Randy M. Suggs

Title

Owner/Administrator

Phone

(910) 892-1241

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1477743151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "address_2": "504 CANAL DRIVE",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283350247",
            "telephone_number": "910-892-1241",
            "fax_number": "910-892-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 CANAL DR",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283342323",
            "telephone_number": "910-892-1241",
            "fax_number": "910-892-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE HEALTH CARE T/A SENIOR CITIZENS VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "SUGGS",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "910-892-1241",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "HAL-043-006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801159",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Denning Miriello, PHARMD
• Anita Mistrough-Orosz
• Serena Alexandria Mitchell, DO
• Willie M. Mitchell
• Wade Mixon, LCAS-A
• Savannah Rae Moran, DO
• James Hugh Morgan, R.P.H.
• Jason M Moss, PHARMD, CPP
• Jaina Mott, MS, OTRL
• Christopher Joseph Mounzer

• Assisted Living Facility in Dunn, NC
• Providers in Dunn, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.