Provider Demographics
NPI:1306626072
Name:NOVIR, LLC
Entity type:Organization
Organization Name:NOVIR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-861-5750
Mailing Address - Street 1:126 N JEFFERSON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6120
Mailing Address - Country:US
Mailing Address - Phone:414-269-9530
Mailing Address - Fax:
Practice Address - Street 1:7342 S ALTON WAY STE H
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2307
Practice Address - Country:US
Practice Address - Phone:414-269-9530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVIR, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-02
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty