Provider Demographics
NPI:1427561083
Name:CLOVVR LLC
Entity Type:Organization
Organization Name:CLOVVR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HANAD
Authorized Official - Middle Name:
Authorized Official - Last Name:DUALE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:614-805-8665
Mailing Address - Street 1:1275 KINNEAR RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1180
Mailing Address - Country:US
Mailing Address - Phone:614-805-8665
Mailing Address - Fax:
Practice Address - Street 1:1566 MONMOUTH DR STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8048
Practice Address - Country:US
Practice Address - Phone:740-653-2224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service