=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093112849
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LOVING ARMS BIRTH AND WELLNESS CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2014
-----------------------------------------------------
Last Update Date | 11/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1111 NE 25TH AVE SUITE 201
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34470-5675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-246-3712
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1111 NE 25TH AVE SUITE 201
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34470-5675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-246-3712
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED MIDWIFE/EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. KARIN L PUGH
-----------------------------------------------------
Credential | LM
-----------------------------------------------------
Telephone | 352-246-3712
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QB0400X
-----------------------------------------------------
Taxonomy Name | Birthing Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------