Provider Demographics
NPI:1689677379
Name:LINCOLN SURGERY PAIN MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:LINCOLN SURGERY PAIN MANAGEMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LINAFELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-484-9090
Mailing Address - Street 1:1710 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1676
Mailing Address - Country:US
Mailing Address - Phone:402-484-9090
Mailing Address - Fax:402-483-0476
Practice Address - Street 1:1730 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1613
Practice Address - Country:US
Practice Address - Phone:402-484-9050
Practice Address - Fax:408-483-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEASC036261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01471OtherBC/BS
NE10024946600Medicaid
NE6800079OtherUNITED HEALTHCARE
NE10024946600Medicaid