Provider Demographics
NPI:1437226560
Name:MEDLINK NETWORK, LLC
Entity Type:Organization
Organization Name:MEDLINK NETWORK, LLC
Other - Org Name:MEDSOURCE HEALTH CARE SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCELYN ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-572-9783
Mailing Address - Street 1:8100 LIBERTY GROVE RD UNIT 100
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-2319
Mailing Address - Country:US
Mailing Address - Phone:972-572-9783
Mailing Address - Fax:972-572-9782
Practice Address - Street 1:8100 LIBERTY GROVE RD UNIT 100
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-2319
Practice Address - Country:US
Practice Address - Phone:972-572-9783
Practice Address - Fax:972-572-9782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010607251E00000X
TX251E00000X
TX017009251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017009OtherSTATE LICENSE NUMBER
TX184479701Medicaid
TX010607OtherSTATE LICENSE NUMBER
TX010607OtherSTATE LICENSE NUMBER
TX679551Medicare PIN