Organization
NOVA GROUP OF MEMPHIS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL MICHAEL BOSTON SR. (PRESIDENT)
(901) 384-4775
Entity
Organization
Contact information
Practice address
6551 STAGE OAKS DR, SUITE 4, BARTLETT, TN 38134-3895
(901) 384-4774
(901) 384-4755
Mailing address
6551 STAGE OAKS DR, SUITE 4, BARTLETT, TN 38134-3895
(901) 384-4774
(901) 384-4755
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00702212
—
MS
05
—
1454942
—
TN
05
—
1636339
—
LA
Enumeration date
05/12/2006
Last updated
08/22/2020
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