Provider Demographics
NPI:1013972272
Name:MEDLINK MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:MEDLINK MANAGEMENT SERVICES INC
Other - Org Name:LAKE BUTLER HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-496-2323
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:LAKE BUTLER
Mailing Address - State:FL
Mailing Address - Zip Code:32054-0748
Mailing Address - Country:US
Mailing Address - Phone:386-496-2323
Mailing Address - Fax:386-496-1611
Practice Address - Street 1:850 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LAKE BUTLER
Practice Address - State:FL
Practice Address - Zip Code:32054
Practice Address - Country:US
Practice Address - Phone:386-496-2323
Practice Address - Fax:386-496-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4290282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010822700Medicaid
FL010822701Medicaid
FL136OtherBLUE CROSS BLUE SHIELD
FL660083201Medicaid
FL72800OtherBLUE CROSS BLUE SHIELD
FL021258000Medicaid
FL660083200Medicaid
FL010822701Medicaid
10-1303Medicare Oscar/Certification