Healthcare Provider Details

I. General information

NPI: 1538715636
Provider Name (Legal Business Name): 3 DOVE MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31201 CHICAGO RD S STE C101
WARREN MI
48093
US

IV. Provider business mailing address

31201 CHICAGO RD S STE C101
WARREN MI
48093-5523
US

V. Phone/Fax

Practice location:
  • Phone: 248-687-4768
  • Fax: 248-479-1819
Mailing address:
  • Phone: 248-687-4768
  • Fax: 248-479-1819

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: ANTHONY KASSAB
Title or Position: OWNER
Credential:
Phone: 248-687-4768