Provider Demographics
NPI:1366103749
Name:PURPLE LILY CARE SOLUTIONS
Entity type:Organization
Organization Name:PURPLE LILY CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SPENCER-MOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-394-9849
Mailing Address - Street 1:4861 COAL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GRANITEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29829-6054
Mailing Address - Country:US
Mailing Address - Phone:706-394-9849
Mailing Address - Fax:
Practice Address - Street 1:900 TRAIL RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7765
Practice Address - Country:US
Practice Address - Phone:706-394-9849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty