Provider Demographics
NPI:1982609012
Name:KIDSLINK, LLC
Entity Type:Organization
Organization Name:KIDSLINK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-757-5312
Mailing Address - Street 1:4003 OUT LOOK DR
Mailing Address - Street 2:STE 2
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9468
Mailing Address - Country:US
Mailing Address - Phone:304-757-5312
Mailing Address - Fax:
Practice Address - Street 1:4003 OUT LOOK DR
Practice Address - Street 2:STE 2
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9468
Practice Address - Country:US
Practice Address - Phone:304-757-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001562Medicaid