1275592263 NPI number — LINK MEDICAL, INC.

Table of content: (NPI 1275592263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275592263 NPI number — LINK MEDICAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINK MEDICAL, INC.
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:
1275592263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 39
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28750-0039
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-894-5700
Provider Business Mailing Address Fax Number:
828-894-5772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 SHUFORD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28722-9411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-894-5700
Provider Business Practice Location Address Fax Number:
828-894-5772
Provider Enumeration Date:
03/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WOMACK
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
828-894-5700

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  00099 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7703687 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".