Provider Demographics
NPI:1255477212
Name:LINKOUS FAMILY HEALTH CARE LLC
Entity type:Organization
Organization Name:LINKOUS FAMILY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LINKOUS
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:304-254-9330
Mailing Address - Street 1:993 RITTER DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:WV
Mailing Address - Zip Code:25813-9556
Mailing Address - Country:US
Mailing Address - Phone:304-254-9330
Mailing Address - Fax:304-254-9335
Practice Address - Street 1:993 RITTER DRIVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:WV
Practice Address - Zip Code:25813
Practice Address - Country:US
Practice Address - Phone:304-254-9330
Practice Address - Fax:304-254-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV39049363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7102128000Medicaid
WV7102128000Medicaid
LINP76162Medicare ID - Type Unspecified
WV9357731Medicare PIN