Provider Demographics
NPI:1649470659
Name:LINC CARE, A JOINT VENTURE
Entity type:Organization
Organization Name:LINC CARE, A JOINT VENTURE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CMO
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:RECKEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-421-0896
Mailing Address - Street 1:8055 O STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2580
Mailing Address - Country:US
Mailing Address - Phone:402-421-0896
Mailing Address - Fax:402-421-0945
Practice Address - Street 1:1601 NORTH 86TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505
Practice Address - Country:US
Practice Address - Phone:402-327-7510
Practice Address - Fax:402-327-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0431930004Medicare NSC