# LIVING WATERS FAMILY MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346950433
- **Authorized official:** LORA COLE (OWNER)
- **Authorized official phone:** (301) 900-5313

## Contact information

- **Practice address:** 1260 MARYLAND AVE STE 114, HAGERSTOWN, MD 21740-7248
- **Practice address phone:** (301) 900-5313
- **Practice address fax:** (301) 235-1590
- **Mailing address:** PO BOX 602, WILLIAMSPORT, MD 21795-0602
- **Mailing address phone:** (301) 900-5313
- **Mailing address fax:** (301) 235-1590

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/29/2022
- **Last updated:** 03/24/2023