Provider Demographics
NPI:1760896302
Name:DOVE HEALTH MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:DOVE HEALTH MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AYODELE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-901-3453
Mailing Address - Street 1:30 HAZEL TER
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2240
Mailing Address - Country:US
Mailing Address - Phone:203-553-9696
Mailing Address - Fax:203-553-9696
Practice Address - Street 1:30 HAZEL TER
Practice Address - Street 2:SUITE 5
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-2240
Practice Address - Country:US
Practice Address - Phone:203-553-9696
Practice Address - Fax:203-553-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1145338332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies