Provider Demographics
NPI:1871080499
Name:LINCOLN MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:LINCOLN MEDICAL SUPPLIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WELWOLIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:571-234-3370
Mailing Address - Street 1:14934 CUMMINGS CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5718
Mailing Address - Country:US
Mailing Address - Phone:571-234-3370
Mailing Address - Fax:703-552-0433
Practice Address - Street 1:14934 CUMMINGS CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5718
Practice Address - Country:US
Practice Address - Phone:571-234-3370
Practice Address - Fax:703-552-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies