=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386716751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LINCARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2006
-----------------------------------------------------
Last Update Date | 01/02/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 149 N BROADWAY AVE
-----------------------------------------------------
City | BOONEVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72927-4009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-675-4060
-----------------------------------------------------
Fax | 479-675-5632
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19387 US HIGHWAY 19 N
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33764-3102
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-431-8110
-----------------------------------------------------
Fax | 877-524-9504
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | PAUL GABOS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 727-431-8215
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------