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Organization

LOVELACE FAMILY MEDICINE, PA

Active
Other names
Lovelace Family Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA M KINARD (PRACTICE MANAGER)
(803) 364-1011
Entity
Organization

Contact information

Practice address
600 N WHEELER AVE, PROSPERITY, SC 29127
(803) 364-4852
(803) 364-2014
Mailing address
PO BOX 630, PROSPERITY, SC 29127-0630
(803) 364-4852
(803) 364-2014

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
SC
291U00000X
Clinical Medical Laboratory
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0739330001
DME/MEDICARE
SC
01
DM0459
DME/MEDICAID
SC
05
GP0018
SC
05
GP3757
SC
Enumeration date
12/23/2005
Last updated
10/02/2007
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