Healthcare Provider Details

I. General information

NPI: 1780030338
Provider Name (Legal Business Name): LOVINGCARE MEDICAL STAFF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 PARK ST
SPRINGDALE AR
72764-5526
US

IV. Provider business mailing address

503 PARK ST
SPRINGDALE AR
72764-5526
US

V. Phone/Fax

Practice location:
  • Phone: 479-430-8480
  • Fax:
Mailing address:
  • Phone: 479-430-8480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN ZOGAL
Title or Position: CEO
Credential:
Phone: 479-430-8480