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Organization
NOVAM-NUTRITION LLC
Active
Organization
NOVAM-NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID LINDSLEY (PRESIDENT)
(855) 416-6826
Entity
Organization
Contact information
Practice address
15455 NW GREENBRIER PKWY, SUITE #100, BEAVERTON, OR 97006-7374
(855) 416-6826
(360) 326-1621
Mailing address
15455 NW GREENBRIER PKWY, SUITE #100, BEAVERTON, OR 97006-7374
(855) 416-6826
(360) 326-1621
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
—
NULL
335G00000X
Medical Foods Supplier
Primary
—
NULL
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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