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NPI Code Detail

MEDICARE: LINCOLN COMMUNITY HEALTH CENTER INCORPORATED

MEDICARE: LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103055OTHERNCGROUP BC/BS ID NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114978582
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINCOLN COMMUNITY HEALTH CENTER INCORPORATED
Provider Business Mailing Address
First Line : PO BOX 52119
Second Line :
City : DURHAM
State : NC
Zip : 27717-2119
Country : US
Telephone Number : 919-956-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1301 FAYETTEVILLE ST
Second Line :
City : DURHAM
State : NC
Zip : 27707-2325
Country : US
Telephone Number : 919-956-4000
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : CLARETTA FOYE
Credential :
Telephone Number : 919-956-4022
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/28/2022

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Directions to “LINCOLN COMMUNITY HEALTH CENTER INCORPORATED ” Practice Location

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