Healthcare Provider Details

I. General information

NPI: 1598254070
Provider Name (Legal Business Name): MORINGA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11604 MOORESTOWN PL
NORTH POTOMAC MD
20878-4275
US

IV. Provider business mailing address

11604 MOORESTOWN PL
NORTH POTOMAC MD
20878-4275
US

V. Phone/Fax

Practice location:
  • Phone: 202-827-3213
  • Fax: 833-464-0121
Mailing address:
  • Phone: 202-827-3213
  • Fax: 833-464-0121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL S WELSH
Title or Position: CEO
Credential:
Phone: 202-827-3213