Provider Demographics
NPI:1518995455
Name:WOMEN'S CLINIC OF LINCOLN, P.C
Entity Type:Organization
Organization Name:WOMEN'S CLINIC OF LINCOLN, P.C
Other - Org Name:FAMILY HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-434-3370
Mailing Address - Street 1:2900 S 70TH
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506
Mailing Address - Country:US
Mailing Address - Phone:402-434-5235
Mailing Address - Fax:402-484-8891
Practice Address - Street 1:220 LYNCREST DRIVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510
Practice Address - Country:US
Practice Address - Phone:402-434-3370
Practice Address - Fax:402-489-0731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMEN'S CLINIC OF LINCOLN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-29
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01965OtherBCBS
NE100252002-00Medicaid
098391Medicare UPIN