Healthcare Provider Details

I. General information

NPI: 1235135583
Provider Name (Legal Business Name): LINCOLN COUNTY OPPORTUNITY COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 MAIN STREET
HAMLIN WV
25523-1412
US

IV. Provider business mailing address

360 MAIN STREET
HAMLIN WV
25523-1412
US

V. Phone/Fax

Practice location:
  • Phone: 304-824-3448
  • Fax: 304-824-7662
Mailing address:
  • Phone: 304-824-3448
  • Fax: 304-824-7662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number517107
License Number StateWV

VIII. Authorized Official

Name: MRS. ALICE J TOMBLIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-824-3448