Provider Demographics
NPI:1215753611
Name:ZOMI MO LLC
Entity type:Organization
Organization Name:ZOMI MO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MANZOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-706-8520
Mailing Address - Street 1:2956 DOUGHERTY FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3366
Mailing Address - Country:US
Mailing Address - Phone:314-706-8520
Mailing Address - Fax:
Practice Address - Street 1:2956 DOUGHERTY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3366
Practice Address - Country:US
Practice Address - Phone:314-706-8520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZOMI MO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies