Provider Demographics
NPI:1548604218
Name:LOVITT 4 LIFE
Entity Type:Organization
Organization Name:LOVITT 4 LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-419-9379
Mailing Address - Street 1:7 LONEY CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-9253
Mailing Address - Country:US
Mailing Address - Phone:336-419-9379
Mailing Address - Fax:
Practice Address - Street 1:7 LONEY CIR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-9253
Practice Address - Country:US
Practice Address - Phone:336-419-9379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization