Provider Demographics
NPI:1609261270
Name:LOVELY DOVES LLC
Entity Type:Organization
Organization Name:LOVELY DOVES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:CHARMAINE
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-230-1918
Mailing Address - Street 1:525 REED ST
Mailing Address - Street 2:33
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-4051
Mailing Address - Country:US
Mailing Address - Phone:843-230-1918
Mailing Address - Fax:
Practice Address - Street 1:525 REED ST APT 33
Practice Address - Street 2:33
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-4051
Practice Address - Country:US
Practice Address - Phone:843-230-1918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization