MEDICARE: LINDEN DRUG CO INC

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	3336C0003X	Community/Retail Pharmacy	16972	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881605871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDEN DRUG CO INC

Provider Business Mailing Address
First Line	:	400 N KAUFMAN ST
Second Line	:
City	:	LINDEN
State	:	TX
Zip	:	75563-5234
Country	:	US
Telephone Number	:	903-756-5331
Fax Number	:	903-756-8143

Provider Business Practice Location Address
First Line	:	400 N KAUFMAN ST
Second Line	:
City	:	LINDEN
State	:	TX
Zip	:	75563-5234
Country	:	US
Telephone Number	:	903-756-5331
Fax Number	:	903-756-8143

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MR. HOWARD ALLAN PAVIA
Credential	:	RPH
Telephone Number	:	903-756-5331

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	12/31/2009

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Directions to “LINDEN DRUG CO INC ” Practice Location

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