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General NPI Number Information
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NPI Number | 1871243832
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Entity Type | Organization
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Legal Business Name | NOVENA MEDICAL, INC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 8518 S 104TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-3236
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Country | US
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Telephone | 877-206-0997
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 460635
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City | PAPILLION
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State | NE
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Zip | 68046
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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 | PRESIDENT
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Name | MR. JAKE HINTON
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Credential |
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Telephone | 877-206-0997
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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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