Organization
INNOVATIVE COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE YARVIS (PRESIDENT)
(219) 767-4444
Entity
Organization
Contact information
Practice address
7891 BROADWAY, SUITE G, MERRILLVILLE, IN 46410-5556
(855) 546-6688
(855) 746-6688
Mailing address
7891 BROADWAY, SUITE G, MERRILLVILLE, IN 46410-5556
(855) 546-6688
(855) 746-6688
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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