Provider Demographics
NPI:1649413022
Name:HOVEROUND CORPORATION
Entity Type:Organization
Organization Name:HOVEROUND CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/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:941-800-2437
Mailing Address - Fax:800-337-0424
Practice Address - Street 1:6415 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-3759
Practice Address - Country:US
Practice Address - Phone:941-739-6200
Practice Address - Fax:800-337-0424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOVEROUND CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-14
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0553540008Medicare NSC