Healthcare Provider Details

I. General information

NPI: 1962436980
Provider Name (Legal Business Name): LINC CARE, A JOINT VENTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 VILLAGE DRIVE
LINCOLN NE
68516-4783
US

IV. Provider business mailing address

8055 'O' ST STE 300
LINCOLN NE
68510-2580
US

V. Phone/Fax

Practice location:
  • Phone: 402-434-7383
  • Fax: 402-434-7382
Mailing address:
  • Phone: 402-421-0896
  • Fax: 402-421-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REX K RECKEWEY
Title or Position: CEO
Credential: MD
Phone: 402-421-0896