Provider Demographics
NPI:1962436980
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
Authorized Official - Prefix:
Authorized Official - First Name:REX
Authorized Official - Middle Name:K
Authorized Official - Last Name:RECKEWEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-421-0896
Mailing Address - Street 1:8055 'O' ST
Mailing Address - Street 2:STE 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 1:3610 VILLAGE DRIVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4783
Practice Address - Country:US
Practice Address - Phone:402-434-7383
Practice Address - Fax:402-434-7382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6600093OtherUHC - LCS
NEF229662OtherMIDLANDS CHOICE - LCS
NEF229664OtherMIDLANDS CHOICE - CC
NE66-00094OtherUHC - LCN
NEF228646OtherMIDLANDS CHOICE - LCN
NE67-00066OtherUHC - CC
NEF229662OtherMIDLANDS CHOICE - LCS