Provider Demographics
NPI:1558508960
Name:MEDLINK
Entity Type:Organization
Organization Name:MEDLINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:402-706-2541
Mailing Address - Street 1:4822 DODGE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3111
Mailing Address - Country:US
Mailing Address - Phone:402-706-2541
Mailing Address - Fax:402-905-2911
Practice Address - Street 1:4822 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3111
Practice Address - Country:US
Practice Address - Phone:402-706-2541
Practice Address - Fax:402-905-2911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty