Healthcare Provider Details

I. General information

NPI: 1720908098
Provider Name (Legal Business Name): LINCOLN DME CARE SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 FORT ST UNIT 224
LINCOLN PARK MI
48146-1937
US

IV. Provider business mailing address

1515 FORT ST UNIT 224
LINCOLN PARK MI
48146-1937
US

V. Phone/Fax

Practice location:
  • Phone: 713-912-0654
  • Fax: 872-309-2063
Mailing address:
  • Phone: 713-912-0654
  • Fax: 872-309-2063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER DIANNE THOMAS
Title or Position: CEO
Credential:
Phone: 713-912-0654