Provider Demographics
NPI:1326013491
Name:LINCOLN HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:LINCOLN HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:BASOENE
Authorized Official - Last Name:SNITHERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-438-6612
Mailing Address - Street 1:540 W INDUSTRIAL LAKE DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68528-1580
Mailing Address - Country:US
Mailing Address - Phone:402-438-6612
Mailing Address - Fax:402-438-6632
Practice Address - Street 1:540 W INDUSTRIAL LAKE DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68528-1580
Practice Address - Country:US
Practice Address - Phone:402-438-6612
Practice Address - Fax:402-438-6632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025316500Medicaid
NE10025316500Medicaid