# MOMENTUM DME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720698186
- **Authorized official:** CHARLES LONG (OWNER)
- **Authorized official phone:** (903) 224-5474

## Contact information

- **Practice address:** 121 S BROADWAY AVE STE 606, TYLER, TX 75702-7281
- **Practice address phone:** (903) 224-5474
- **Mailing address:** 121 S BROADWAY AVE STE 606, TYLER, TX 75702-7281

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 07/31/2020
- **Last updated:** 10/06/2020