Provider Demographics
NPI:1407307218
Name:MOMS BREAST PUMPS
Entity Type:Organization
Organization Name:MOMS BREAST PUMPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KABIRU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-347-8100
Mailing Address - Street 1:510 N PARK RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2941
Mailing Address - Country:US
Mailing Address - Phone:484-347-8100
Mailing Address - Fax:
Practice Address - Street 1:510 N PARK RD STE 1
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2941
Practice Address - Country:US
Practice Address - Phone:484-347-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies