| 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 |