Provider Demographics
NPI:1881907384
Name:LINCOLN MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:LINCOLN MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:FARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-288-8844
Mailing Address - Street 1:PO BOX 9359
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-9359
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22820 I-45 NORTH H-I
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-0000
Practice Address - Country:US
Practice Address - Phone:281-288-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN MEDICAL SUPPLY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty