Provider Demographics
NPI:1083496459
Name:MAKING MOMMIES LLC
Entity Type:Organization
Organization Name:MAKING MOMMIES LLC
Other - Org Name:MAKING MOMMIES MIDWIFERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMMORI
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM, IBCLC
Authorized Official - Phone:626-716-6324
Mailing Address - Street 1:4140 E PINTO LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8981
Mailing Address - Country:US
Mailing Address - Phone:626-716-6324
Mailing Address - Fax:
Practice Address - Street 1:13951 N SCOTTSDALE RD STE 110
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3454
Practice Address - Country:US
Practice Address - Phone:626-716-6324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1013496322Medicaid