1962436980 NPI number — LINC CARE, A JOINT VENTURE

Table of content: (NPI 1962436980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962436980 NPI number — LINC CARE, A JOINT VENTURE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINC CARE, A JOINT VENTURE
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:
COMPANY CARE
Provider Other Organization Name Type Code:
3
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:
1962436980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8055 'O' ST
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68510-2580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-421-0896
Provider Business Mailing Address Fax Number:
402-421-0945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3610 VILLAGE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68516-4783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-434-7383
Provider Business Practice Location Address Fax Number:
402-434-7382
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RECKEWEY
Authorized Official First Name:
REX
Authorized Official Middle Name:
K
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
402-421-0896

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QX0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 6600093 . This is a "UHC - LCS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: F229662 . This is a "MIDLANDS CHOICE - LCS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: F229664 . This is a "MIDLANDS CHOICE - CC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 66-00094 . This is a "UHC - LCN" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: F228646 . This is a "MIDLANDS CHOICE - LCN" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 67-00066 . This is a "UHC - CC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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