Provider Demographics
NPI:1649740911
Name:MOOV LLC
Entity type:Organization
Organization Name:MOOV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEROGATIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-527-6166
Mailing Address - Street 1:1901 JOHN MCCAIN RD STE F
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6334
Mailing Address - Country:US
Mailing Address - Phone:817-410-7261
Mailing Address - Fax:817-394-1603
Practice Address - Street 1:1901 JOHN MCCAIN RD STE F
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6334
Practice Address - Country:US
Practice Address - Phone:817-410-7261
Practice Address - Fax:817-394-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies