Provider Demographics
NPI:1942172762
Name:MOXIE CREW LLC
Entity type:Organization
Organization Name:MOXIE CREW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:HIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-406-8979
Mailing Address - Street 1:1101 SPY GLASS WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-5244
Mailing Address - Country:US
Mailing Address - Phone:865-406-8979
Mailing Address - Fax:
Practice Address - Street 1:1100 REVOLUTION MILL DR STE 5
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5068
Practice Address - Country:US
Practice Address - Phone:865-408-8423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory