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General NPI Number Information
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NPI Number | 1013545359
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Entity Type | Organization
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Legal Business Name | SOVR DISTRIBUTION NETWORK, LLC
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 11 W 36TH ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10018-7146
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Country | US
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Telephone | 404-518-0974
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Fax |
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Provider Business Mailing Address
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Address Line | 11 W 36TH ST
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City | NEW YORK
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State | NY
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Zip | 10018-7913
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | SHIMITE OBIALO
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Credential |
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Telephone | 404-518-0974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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