Provider Demographics
NPI:1215727474
Name:LINCOLN PHARMACY, INC.
Entity type:Organization
Organization Name:LINCOLN PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUGEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:701-333-8054
Mailing Address - Street 1:105 MCDOUGALL DR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ND
Mailing Address - Zip Code:58504-1300
Mailing Address - Country:US
Mailing Address - Phone:701-333-8054
Mailing Address - Fax:
Practice Address - Street 1:105 MCDOUGALL DR UNIT 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ND
Practice Address - Zip Code:58504-1300
Practice Address - Country:US
Practice Address - Phone:701-333-8054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy