MEDICARE: SHONDA BEAUMAN LOVE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	10257247	TX

General Provider Information

NPI Number	:	1932878220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHONDA BEAUMAN LOVE

Provider Business Mailing Address
First Line	:	239 STONEGATE WAY
Second Line	:
City	:	RED OAK
State	:	TX
Zip	:	75154-5019
Country	:	US
Telephone Number	:	682-386-8051
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 STONEGATE WAY
Second Line	:
City	:	RED OAK
State	:	TX
Zip	:	75154-5019
Country	:	US
Telephone Number	:	682-386-8051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	09/09/2021

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Directions to “ SHONDA BEAUMAN LOVE ” Practice Location

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