Organization Name: | LOVELACE FAMILY MEDICINE, PA |
NPI Number: | 1366429987 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA M KINARD (PRACTICE MANAGER) |
Mailing Address: | 600 N Wheeler Ave Prosperity |
State: | SC US |
Postal Code: | 29127 |
Phone Number: | 8033644852 |
Fax Number: | 8033642014 |
NPI Enumeration Date: | 12/23/2005 |
NPI Last Update Date: | 10/02/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |