Provider Demographics
NPI:1497817753
Name:DOVE MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:DOVE MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:606-364-7575
Mailing Address - Street 1:510 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40741-1943
Mailing Address - Country:US
Mailing Address - Phone:606-364-7575
Mailing Address - Fax:
Practice Address - Street 1:3924 HWY 30 WEST
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:KY
Practice Address - Zip Code:40402-8725
Practice Address - Country:US
Practice Address - Phone:606-364-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1033163068
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-14
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000075258OtherBLUE CROSS AND BLUE SHIELD
KY7100020540Medicaid
KY1275400002Medicare NSC