Provider Demographics
NPI:1407225584
Name:LORINE'S TENDER CARE, LLC
Entity Type:Organization
Organization Name:LORINE'S TENDER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:352-286-8100
Mailing Address - Street 1:1636 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34475-6037
Mailing Address - Country:US
Mailing Address - Phone:352-286-8100
Mailing Address - Fax:
Practice Address - Street 1:1636 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-6037
Practice Address - Country:US
Practice Address - Phone:352-286-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization