Provider Demographics
NPI:1073754669
Name:TIFFANI LOVES CLEVELAND
Entity Type:Organization
Organization Name:TIFFANI LOVES CLEVELAND
Other - Org Name:TLC DIABETIC AND MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLEVELAND
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:910-977-6044
Mailing Address - Street 1:208 BROOKE RUN
Mailing Address - Street 2:
Mailing Address - City:LUMBER BRIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:28357-8780
Mailing Address - Country:US
Mailing Address - Phone:910-977-6044
Mailing Address - Fax:
Practice Address - Street 1:208 BROOKE RUN
Practice Address - Street 2:
Practice Address - City:LUMBER BRIDGE
Practice Address - State:NC
Practice Address - Zip Code:28357-8780
Practice Address - Country:US
Practice Address - Phone:910-977-6044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies