Provider Demographics
NPI:1932540846
Name:INNOVATIONS HEALTH DEVICES LLC
Entity Type:Organization
Organization Name:INNOVATIONS HEALTH DEVICES LLC
Other - Org Name:KINOVA USA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-468-0358
Mailing Address - Street 1:1009 ENTERPRISE WAY STE 350
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-3019
Mailing Address - Country:US
Mailing Address - Phone:916-468-0358
Mailing Address - Fax:916-791-0585
Practice Address - Street 1:1009 ENTERPRISE WAY STE 350
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3019
Practice Address - Country:US
Practice Address - Phone:916-468-0358
Practice Address - Fax:916-791-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23550332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies