Provider Demographics
NPI:1578606075
Name:NOVEL MEDICAL LLC
Entity Type:Organization
Organization Name:NOVEL MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:COCANOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-473-1737
Mailing Address - Street 1:445 CROSS POINTE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4012
Mailing Address - Country:US
Mailing Address - Phone:812-962-1540
Mailing Address - Fax:812-962-1545
Practice Address - Street 1:445 CROSS POINTE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4012
Practice Address - Country:US
Practice Address - Phone:812-962-1540
Practice Address - Fax:812-962-1545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0111420156332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies