Healthcare Provider Details

I. General information

NPI: 1609248384
Provider Name (Legal Business Name): LORI FLOWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2015
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 2ND LOOP RD STE 7
FLORENCE SC
29501-6180
US

IV. Provider business mailing address

1800 2ND LOOP RD STE 7
FLORENCE SC
29501-6180
US

V. Phone/Fax

Practice location:
  • Phone: 843-800-1355
  • Fax: 843-800-1352
Mailing address:
  • Phone: 843-800-1355
  • Fax: 843-800-1352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberIHCP-0157
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: