Provider Demographics
NPI:1780240481
Name:LOVING HANDS WELLNESS & PRIMARY CARE
Entity type:Organization
Organization Name:LOVING HANDS WELLNESS & PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:QUEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BETHEA
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:252-813-2933
Mailing Address - Street 1:170 FOREST LAKES RD
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-7364
Mailing Address - Country:US
Mailing Address - Phone:252-813-2933
Mailing Address - Fax:
Practice Address - Street 1:1006 N ARENDELL AVE
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-2352
Practice Address - Country:US
Practice Address - Phone:252-813-2933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty