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General NPI Number Information
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NPI Number | 1962223081
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Entity Type | Organization
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Legal Business Name | MOMENTO LLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 16304 HIDDEN COVE DR
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City | CELINA
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State | TX
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Zip | 75009-2062
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Country | US
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Telephone | 469-441-9241
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Fax |
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Provider Business Mailing Address
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Address Line | 16304 HIDDEN COVE DR
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City | CELINA
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State | TX
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Zip | 75009-2062
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Country | US
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Telephone | 469-441-9241
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | SOHAIB QAZI
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Credential |
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Telephone | 469-441-9241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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