Provider Demographics
NPI:1922479401
Name:HOVLAND HEALTHCARE PRODUCTS, LLC
Entity Type:Organization
Organization Name:HOVLAND HEALTHCARE PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TORREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HOVLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:701-388-9731
Mailing Address - Street 1:24864 TRI LAKES DR
Mailing Address - Street 2:
Mailing Address - City:PELICAN RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56572-7555
Mailing Address - Country:US
Mailing Address - Phone:701-388-9731
Mailing Address - Fax:218-585-7305
Practice Address - Street 1:24864 TRI LAKES DR
Practice Address - Street 2:
Practice Address - City:PELICAN RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56572-7555
Practice Address - Country:US
Practice Address - Phone:701-388-9731
Practice Address - Fax:218-585-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104222332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies