Provider Demographics
NPI:1023293404
Name:LINCH, RITA (BA)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:LINCH
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 MCGLATHERY LANE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601
Mailing Address - Country:US
Mailing Address - Phone:256-355-3703
Mailing Address - Fax:256-355-3704
Practice Address - Street 1:501 MCGLATHERY LANE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-6055
Practice Address - Country:US
Practice Address - Phone:256-355-3703
Practice Address - Fax:256-355-3704
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL590000025Medicaid