Basic Information
| Provider Information | |||||||||
| NPI: | 1124181565 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LINCARE INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19387 US HIGHWAY 19 N | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337643102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002842006 | ||||||||
| FaxNumber: | 8775249504 | ||||||||
| Practice Location | |||||||||
| Address1: | 5020 HERZEL PL | ||||||||
| Address2: | |||||||||
| City: | BELTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207052008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019373082 | ||||||||
| FaxNumber: | 3019373543 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 07/28/2021 | ||||||||
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| AuthorizedOfficialLastName: | MCCARTHY | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATIONS OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7275307700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 07/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | 032919500 | 05 | DC | MEDICAID | 100013600 | 05 | MD | MEDICAID | 1124181565 | 05 | VA | MEDICAID |