Provider Demographics
NPI:1467993352
Name:LOVING HANDS DIRECTED MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:LOVING HANDS DIRECTED MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:REINHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-990-2963
Mailing Address - Street 1:519 W MONTICELLO ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-3209
Mailing Address - Country:US
Mailing Address - Phone:601-990-2963
Mailing Address - Fax:877-211-5123
Practice Address - Street 1:519 W MONTICELLO ST
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-3209
Practice Address - Country:US
Practice Address - Phone:601-990-2963
Practice Address - Fax:877-211-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS17415261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care