Provider Demographics
NPI:1619655131
Name:MEDLINK HOMECARE LLC
Entity Type:Organization
Organization Name:MEDLINK HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:TRENELL
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:980-263-8436
Mailing Address - Street 1:2307 W CONE BLVD STE 110A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4063
Mailing Address - Country:US
Mailing Address - Phone:276-444-1814
Mailing Address - Fax:
Practice Address - Street 1:2307 W CONE BLVD STE 110A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4063
Practice Address - Country:US
Practice Address - Phone:276-444-1814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health