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General NPI Number Information
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NPI Number | 1922479401
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Entity Type | Organization
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Legal Business Name | HOVLAND HEALTHCARE PRODUCTS, LLC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 24864 TRI LAKES DR
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City | PELICAN RAPIDS
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State | MN
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Zip | 56572-7555
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Country | US
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Telephone | 701-388-9731
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Fax | 218-585-7305
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Provider Business Mailing Address
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Address Line | 24864 TRI LAKES DR
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City | PELICAN RAPIDS
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State | MN
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Zip | 56572-7555
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Country | US
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Telephone | 701-388-9731
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Fax | 218-585-7305
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Authorized Official
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Title or Position | OWNER
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Name | TORREY LEE HOVLAND
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Credential | OTR/L
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Telephone | 701-388-9731
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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 | 104222
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License Number State | MN
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