1003266560 NPI number — LINCOLN HOSPITALIST ASSOCIATES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003266560 NPI number — LINCOLN HOSPITALIST ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINCOLN HOSPITALIST ASSOCIATES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003266560
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 S. 48TH STREET
Provider Second Line Business Mailing Address:
SUITE 708
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68506-3418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-483-8617
Provider Business Mailing Address Fax Number:
402-483-8698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 S. 48TH STREET
Provider Second Line Business Practice Location Address:
SUITE 708
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68506-3418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-483-8617
Provider Business Practice Location Address Fax Number:
402-483-8698
Provider Enumeration Date:
06/15/2016

Additional Information

Authorized Official

Authorized Official Last Name:
FOUGERON
Authorized Official First Name:
ABBIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
402-483-8613

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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