Provider Demographics
NPI:1740648435
Name:NOVA DME LLC
Entity type:Organization
Organization Name:NOVA DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KATSCHANOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-250-3393
Mailing Address - Street 1:26222 TELEGRAPH RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-5318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26222 TELEGRAPH RD
Practice Address - Street 2:STE 300
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-5318
Practice Address - Country:US
Practice Address - Phone:248-250-3393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies