| Lovelace Family Medicine, Pa | |
| 
					600 N Wheeler Ave Prosperity SC 29127  | |
| (803) 364-4852 | |
| (803) 364-2014 | 
| Full Name | Lovelace Family Medicine, Pa | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 600 N Wheeler Ave, Prosperity, South Carolina | 
| Authorized Official Name and Position | Linda M Kinard (PRACTICE MANAGER) | 
| Authorized Official Contact | 8033641011 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Lovelace Family Medicine, Pa Po Box 630 Prosperity SC 29127-0630 Ph: (803) 364-4852  | Lovelace Family Medicine, Pa 600 N Wheeler Ave Prosperity SC 29127 Ph: (803) 364-4852  | 
| NPI Number | 1366429987 | 
|---|---|
| Provider Enumeration Date | 12/23/2005 | 
| Last Update Date | 10/02/2007 | 
| Medicare PECOS PAC ID | 6002719655 | 
|---|---|
| Medicare Enrollment ID | O20040130000193 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1366429987 | NPI | - | NPPES | 
| GP3757 | Medicaid | SC | |
| 0739330001 | Other | SC | DME/MEDICARE | 
| DM0459 | Other | SC | DME/MEDICAID | 
| GP0018 | Medicaid | SC | 
| Provider Name | Paul M Espinoza | 
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease | 
| Provider Identifiers | NPI Number: 1780613455 PECOS PAC ID: 5395795876 Enrollment ID: I20050124000607  | 
| Provider Name | Amanda T Haltiwanger | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1649432477 PECOS PAC ID: 5597830737 Enrollment ID: I20080822000005  | 
| Provider Name | Lindsay W Piersol | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1932372067 PECOS PAC ID: 3577626688 Enrollment ID: I20090610000215  | 
| Provider Name | Rhonda L Cook | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699752345 PECOS PAC ID: 7315133154 Enrollment ID: I20101119000080  | 
| Provider Name | William M Dixon | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1710964416 PECOS PAC ID: 9234168162 Enrollment ID: I20101221000527  | 
| Provider Name | Oscar F Lovelace | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1982681680 PECOS PAC ID: 9537062187 Enrollment ID: I20110211000571  | 
| Provider Name | Spencer Lovelace | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1730524620 PECOS PAC ID: 7315261104 Enrollment ID: I20160906000593  | 
| Provider Name | Monica Y Taylor | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1649544545 PECOS PAC ID: 8527215201 Enrollment ID: I20200224001071  | 
| Provider Name | Dianna P Kubacz | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1396903068 PECOS PAC ID: 1153477948 Enrollment ID: I20200414000815  | 
| Provider Name | Dean B Kubacz | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1023276896 PECOS PAC ID: 6608921952 Enrollment ID: I20200624001098  | 
| Provider Name | Allie C Redding | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1427686047 PECOS PAC ID: 0446678627 Enrollment ID: I20220728000406  | 
| Provider Name | Lance Braye | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1215420195 PECOS PAC ID: 5395097133 Enrollment ID: I20221109000238  |