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NPI Code Detail

MEDICARE: LINCOLN COUNTY OPPORTUNITY COMPANY, INC.

MEDICARE: LINCOLN COUNTY OPPORTUNITY COMPANY, INC.
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
1251E00000XHome Health Agency517107WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
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
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235135583
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINCOLN COUNTY OPPORTUNITY COMPANY, INC.
Provider Business Mailing Address
First Line : 360 MAIN STREET
Second Line :
City : HAMLIN
State : WV
Zip : 25523-1412
Country : US
Telephone Number : 304-824-3448
Fax Number : 304-824-7662
Provider Business Practice Location Address
First Line : 360 MAIN STREET
Second Line :
City : HAMLIN
State : WV
Zip : 25523-1412
Country : US
Telephone Number : 304-824-3448
Fax Number : 304-824-7662
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. ALICE J TOMBLIN
Credential :
Telephone Number : 304-824-3448
Provider Enumeration Date : 06/22/2005
Last Update Date : 08/22/2020

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1992840474 — LINCOLN COUNTY OPPORTUNITY COMPANY INC
Practice Location Address:
360 MAIN ST
HAMLIN, WV
25523-1412
Practice Phone: 304-824-3448
Practice Fax: 304-824-7662

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