MEDICARE: NEW LINCOLN LTD

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
1	310400000X	Assisted Living Facility	2487R	OH

General Provider Information

NPI Number	:	1275786485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LINCOLN LTD

Provider Business Mailing Address
First Line	:	4950 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-1653
Country	:	US
Telephone Number	:	614-870-1123
Fax Number	:	614-853-2509

Provider Business Practice Location Address
First Line	:	4950 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-1653
Country	:	US
Telephone Number	:	614-870-1123
Fax Number	:	614-853-2509

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	CAROL GROEBER
Credential	:
Telephone Number	:	937-964-8974

Provider Enumeration Date	:	10/31/2008
Last Update Date	:	10/31/2008

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