Healthcare Provider Details

I. General information

NPI: 1366611642
Provider Name (Legal Business Name): LINCO HEALTHCARE SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 THE OAKS
CLARKSTON GA
30021-1233
US

IV. Provider business mailing address

2802 THE OAKS
CLARKSTON GA
30021-1233
US

V. Phone/Fax

Practice location:
  • Phone: 678-334-9239
  • Fax: 404-298-3240
Mailing address:
  • Phone: 678-334-9239
  • Fax: 404-298-3240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateGA

VIII. Authorized Official

Name: MS. ROSE A WILSON HILL
Title or Position: PRESIDENT
Credential:
Phone: 678-334-9239