Organization
NOVA 1 CORP
Active
Other names
Grove Pharmacy & AA Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND G WEISBEIN (PRESIDENT)
(305) 662-4477
Entity
Organization
Contact information
Practice address
3692 GRAND AVE, STE B, MIAMI, FL 33133-4953
(305) 662-4477
Mailing address
1234 S DIXIE HWY, SUITE 324, CORAL GABLES, FL 33146-2902
(305) 662-4477
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25630
FL
Other
Enumeration date
07/02/2006
Last updated
01/29/2013
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