Provider Demographics
NPI:1720351786
Name:HOVEROUND CORPORATION
Entity type:Organization
Organization Name:HOVEROUND CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRERICHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-739-6200
Mailing Address - Street 1:6015 31ST ST E STE 201
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-5317
Mailing Address - Country:US
Mailing Address - Phone:941-739-6200
Mailing Address - Fax:800-337-0424
Practice Address - Street 1:116 SPACE PARK S
Practice Address - Street 2:SPACE PARK SOUTH SERVICE CENTER #2
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3113
Practice Address - Country:US
Practice Address - Phone:941-782-6622
Practice Address - Fax:800-337-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000476332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1531918Medicaid