Organization
INNOVA MEDICAL GROUP LLC
Active
Parent organization
INNOVA-SG CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
INNOVA-SG CORP
Authorized official
MICHAEL PECK (PRESIDENT)
(617) 515-3970
Entity
Organization
Contact information
Practice address
669 BOSTON POST RD STE 8, GUILFORD, CT 06437-2739
(833) 446-6682
Mailing address
669 BOSTON POST RD STE 8, GUILFORD, CT 06437-2739
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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