Provider Demographics
NPI:1609507409
Name:LINCOLN COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:LINCOLN COMMUNITY HOSPITAL
Other - Org Name:LINCOLN HEALTH BYERS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
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:719-743-2063
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:719-743-2355
Practice Address - Street 1:404 E FRONT ST
Practice Address - Street 2:
Practice Address - City:BYERS
Practice Address - State:CO
Practice Address - Zip Code:80103-9727
Practice Address - Country:US
Practice Address - Phone:303-822-5100
Practice Address - Fax:303-822-5106
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-22
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty