Provider Demographics
NPI:1730295593
Name:LINCOLN COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:LINCOLN COMMUNITY HOSPITAL
Other - Org Name:LINCOLN COMMUNITY HOME HEALTH & HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF NURSING ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
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
Mailing Address - Country:US
Mailing Address - Phone:719-743-2797
Mailing Address - Fax:719-743-2008
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:719-743-2797
Practice Address - Fax:719-743-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1069251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64239713Medicaid
CO64239713Medicaid