Healthcare Provider Details

I. General information

NPI: 1881561108
Provider Name (Legal Business Name): DVENTAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3816 ASPEN SPGS NW
KENNESAW GA
30144-1093
US

IV. Provider business mailing address

3816 ASPEN SPGS NW
KENNESAW GA
30144-1093
US

V. Phone/Fax

Practice location:
  • Phone: 678-488-7671
  • Fax:
Mailing address:
  • Phone: 478-255-2915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ALEX JOHN
Title or Position: BILLING MANAGER
Credential:
Phone: 478-255-2915