Provider Demographics
NPI:1134125339
Name:LINCOLN ENTERPRISES
Entity Type:Organization
Organization Name:LINCOLN ENTERPRISES
Other - Org Name:LINCOLN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-821-3332
Mailing Address - Street 1:232 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2502
Mailing Address - Country:US
Mailing Address - Phone:412-821-3332
Mailing Address - Fax:412-821-8071
Practice Address - Street 1:232 NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15209-2502
Practice Address - Country:US
Practice Address - Phone:412-821-3332
Practice Address - Fax:412-821-8071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP411386L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100728559004Medicaid
3909326OtherNABP
PAPP411386LOtherPA STATE PHARMACY PERMIT
AC1676545OtherDEA NUMBER
PAPP411386LOtherPA STATE PHARMACY PERMIT