Provider Demographics
NPI:1033163068
Name:DOVE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:DOVE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CECIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-864-7144
Mailing Address - Street 1:510 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741
Mailing Address - Country:US
Mailing Address - Phone:606-864-7144
Mailing Address - Fax:606-877-6505
Practice Address - Street 1:510 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741
Practice Address - Country:US
Practice Address - Phone:606-864-7144
Practice Address - Fax:606-877-6505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY45000049OtherMEDICAID SPECIAL SERVICES
KY000000075258OtherBCBS
KY90000019Medicaid
00400202OtherUS DEPARTMENT OF LABOR
KY1275400001Medicare ID - Type Unspecified