Provider Demographics
NPI:1578188074
Name:LINCOLN COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:LINCOLN COMMUNITY HOSPITAL
Other - Org Name:LINCOLN HEALTH GORDON FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-743-2421
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:CO
Mailing Address - Zip Code:80821-0248
Mailing Address - Country:US
Mailing Address - Phone:719-743-2421
Mailing Address - Fax:
Practice Address - Street 1:111 6TH ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-2002
Practice Address - Country:US
Practice Address - Phone:719-743-2421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-10
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty