Provider Demographics
NPI:1962223081
Name:MOMENTO LLC
Entity type:Organization
Organization Name:MOMENTO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SOHAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-441-9241
Mailing Address - Street 1:16304 HIDDEN COVE DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-2062
Mailing Address - Country:US
Mailing Address - Phone:469-441-9241
Mailing Address - Fax:
Practice Address - Street 1:16304 HIDDEN COVE DR
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-2062
Practice Address - Country:US
Practice Address - Phone:469-441-9241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies