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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Moicano Healthcare Provider | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | Provider ID: 0103628 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | Waivered Services Organization | [sources] | |||
| Address | 1116 Hicks Blvd, Fairfield, OH 45014 | [sources] | |||
| Last change | Last processed | First seen | |||
For experts: raw data explorer
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| Address | ||
|---|---|---|
| Full address | Country | |
| 1116 Hicks Blvd, Fairfield, OH 45014 | United States | |