MEDICARE: CHLOLINDAK CORPORATION

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	29351	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2143228	OTHER		PK

General Provider Information

NPI Number	:	1609283068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHLOLINDAK CORPORATION

Provider Business Mailing Address
First Line	:	4832 MOUNT HOUSTON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-1633
Country	:	US
Telephone Number	:	281-987-3300
Fax Number	:	281-987-3302

Provider Business Practice Location Address
First Line	:	4832 MOUNT HOUSTON RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77093-1633
Country	:	US
Telephone Number	:	281-987-3300
Fax Number	:	281-987-3302

Authorized Official
Title or Position	:	OWNER
Name	:	LINDA BANH
Credential	:
Telephone Number	:	832-398-9589

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	10/28/2014

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Directions to “CHLOLINDAK CORPORATION ” Practice Location

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