Basic Information
| Provider Information | |||||||||
| NPI: | 1295896199 | ||||||||
| 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: | 1750 S RAILROAD SPRINGS BLVD STE 10 | ||||||||
| Address2: | |||||||||
| City: | FLAGSTAFF | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 860017224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9287792886 | ||||||||
| FaxNumber: | 9287794498 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 05/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | MCCARTHY | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF OPERATIONS OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2722592255 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | AO | ||||||||
| NPICertificationDate: | 05/10/2022 | ||||||||
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 | 765846 | 05 | AZ | MEDICAID |