Provider Demographics
NPI:1720107519
Name:LINCOLN COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:LINCOLN COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-743-2421
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:CO
Mailing Address - Zip Code:80821-0248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 6TH ST.
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:CO
Practice Address - Zip Code:80821-0248
Practice Address - Country:US
Practice Address - Phone:719-743-2421
Practice Address - Fax:719-623-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO010150207Q00000X, 275N00000X, 282NC0060X
CO17X799251E00000X, 251G00000X
261QD0000X, 282NC0060X, 341600000X, 343900000X
CO05653688314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251G00000XAgenciesHospice Care, Community Based
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05062005Medicaid
CO05653688Medicaid
CO05655907Medicaid
CO05701735Medicaid
CO061306Medicare Oscar/Certification
CO05655907Medicaid
CO05653688Medicaid
CO05062005Medicaid
CO061552Medicare Oscar/Certification