Provider Demographics
NPI:1821038662
Name:LINCOLN HEALTH SYSTEM
Entity Type:Organization
Organization Name:LINCOLN HEALTH SYSTEM
Other - Org Name:LINCOLN MEDICAL CENTER HHA
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-355-2154
Mailing Address - Street 1:PO BOX 32861
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28232-2861
Mailing Address - Country:US
Mailing Address - Phone:704-355-2000
Mailing Address - Fax:704-355-5073
Practice Address - Street 1:200 GAMBLE DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4421
Practice Address - Country:US
Practice Address - Phone:704-512-2300
Practice Address - Fax:704-561-8532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC347191Medicare Oscar/Certification