Provider Demographics
NPI:1689438053
Name:HANOVER CARDIAC ASC LLC
Entity Type:Organization
Organization Name:HANOVER CARDIAC ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PINDIPAPANAHALLI
Authorized Official - Middle Name:V
Authorized Official - Last Name:RAVINDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-800-6600
Mailing Address - Street 1:8243 MEADOWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2329
Mailing Address - Country:US
Mailing Address - Phone:804-665-0770
Mailing Address - Fax:
Practice Address - Street 1:8160 PLEASANT GROVE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-665-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical