Healthcare Provider Details

I. General information

NPI: 1265191787
Provider Name (Legal Business Name): LYFE INTEGRATED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2494 COUNTRY CLUB DRIVE
LANCASTER SC
29720-2972
US

IV. Provider business mailing address

501 N MAIN ST UNIT 1536
LANCASTER SC
29721-0349
US

V. Phone/Fax

Practice location:
  • Phone: 803-804-4501
  • Fax:
Mailing address:
  • Phone: 803-804-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHARIKA TALFORD
Title or Position: FAMILY NURSE PRACTITIONER OWNER.OPE
Credential: MSN APRN FNP-C
Phone: 803-804-4501