Provider Demographics
NPI:1033374517
Name:HOVEROUND CORPORATION
Entity Type:Organization
Organization Name:HOVEROUND CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-739-6200
Mailing Address - Street 1:6015 31ST ST E STE 201
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-5317
Mailing Address - Country:US
Mailing Address - Phone:941-739-6200
Mailing Address - Fax:800-337-0424
Practice Address - Street 1:4913 CHASTAIN AVE
Practice Address - Street 2:UNIT 33
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2248
Practice Address - Country:US
Practice Address - Phone:704-672-9998
Practice Address - Fax:800-337-0424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOVEROUND CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-23
Last Update Date:2023-04-27
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
NC7704975Medicaid
NC7704975Medicaid