1326013491 NPI number — LINCOLN HEALTHCARE SERVICES

Table of content: (NPI 1326013491)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326013491 NPI number — LINCOLN HEALTHCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LINCOLN HEALTHCARE SERVICES
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:
1326013491
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:
540 W INDUSTRIAL LAKE DR
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
LINCOLN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68528-1580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-438-6612
Provider Business Mailing Address Fax Number:
402-438-6632

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
540 W INDUSTRIAL LAKE DR
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
LINCOLN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68528-1580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-438-6612
Provider Business Practice Location Address Fax Number:
402-438-6632
Provider Enumeration Date:
02/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SNITHERS
Authorized Official First Name:
LINCOLN
Authorized Official Middle Name:
BASOENE
Authorized Official Title or Position:
OWNER/DIRECTOR
Authorized Official Telephone Number:
402-438-6612

Provider Taxonomy Codes

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

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

  • Identifier: 10025316500 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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