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NPI Code Detail

MEDICARE: ALCOVE VENTURES LLC

MEDICARE: ALCOVE VENTURES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1093191322
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALCOVE VENTURES LLC
Provider Business Mailing Address
First Line : 3593 MEDINA RD
Second Line : SUITE 181
City : MEDINA
State : OH
Zip : 44256-8182
Country : US
Telephone Number : 330-536-3746
Fax Number : 866-519-5293
Provider Business Practice Location Address
First Line : 10603 DETROIT AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44102-1647
Country : US
Telephone Number : 330-536-3746
Fax Number :
Authorized Official
Title or Position : SVP
Name : BRIAN NICHOLS
Credential :
Telephone Number : 330-536-3746
Provider Enumeration Date : 08/10/2015
Last Update Date : 04/24/2025

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Directions to “ALCOVE VENTURES LLC ” Practice Location

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