1912509969 NPI number — LOVE MATTERS, LLC

Table of content: (NPI 1912509969)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912509969 NPI number — LOVE MATTERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOVE MATTERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912509969
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
732 DIAL CREEK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELGIN
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29045-2003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-800-7187
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
136 FORUM DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29229-7942
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-251-9465
Provider Business Practice Location Address Fax Number:
866-736-0574
Provider Enumeration Date:
11/13/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOVE
Authorized Official First Name:
LATRICE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
803-800-7187

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FP1506 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".