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General NPI Number Information
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NPI Number | 1700536422
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Entity Type | Organization
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Legal Business Name | LINCOLN ONE HEALTH LLC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 2825 3RD AVE # 2
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City | BRONX
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State | NY
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Zip | 10455-4066
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Country | US
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Telephone | 917-792-2411
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Fax | 917-792-2414
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Provider Business Mailing Address
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Address Line | 2825 3RD AVE # 2
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City | BRONX
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State | NY
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Zip | 10455-4066
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Country | US
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Telephone | 917-792-2411
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Fax | 917-792-2414
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIRVICE AHMAD
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Credential |
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Telephone | 347-896-3441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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