| Dove Hydration & Wellness, Llc | |
|
950 N 35th St Fl 2 Milwaukee WI 53208-3318 | |
| (414) 775-7739 | |
| Not Available |
| Full Name | Dove Hydration & Wellness, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 950 N 35th St Fl 2, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Lillian Morenike Oduwole (DIRECTOR / OWNER) |
| Authorized Official Contact | 4147757739 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dove Hydration & Wellness, Llc 950 N 35th St Fl 2 Milwaukee WI 53208-3318 Ph: (414) 775-7739 | Dove Hydration & Wellness, Llc 950 N 35th St Fl 2 Milwaukee WI 53208-3318 Ph: (414) 775-7739 |
| NPI Number | 1376226464 |
|---|---|
| Provider Enumeration Date | 08/08/2023 |
| Last Update Date | 08/08/2023 |
| Medicare PECOS PAC ID | 1759744451 |
|---|---|
| Medicare Enrollment ID | O20230829000939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376226464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| Provider Name | Cynthia C White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700562865 PECOS PAC ID: 7113379793 Enrollment ID: I20240118004248 |
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