Provider Demographics
NPI:1386369734
Name:DOVAMED MEDICAL
Entity type:Organization
Organization Name:DOVAMED MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-406-1886
Mailing Address - Street 1:545 MAINSTREAM DR STE 102
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1211
Mailing Address - Country:US
Mailing Address - Phone:615-406-1886
Mailing Address - Fax:
Practice Address - Street 1:545 MAINSTREAM DR STE 102
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1211
Practice Address - Country:US
Practice Address - Phone:615-406-1886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies