Healthcare Provider Details

I. General information

NPI: 1306930714
Provider Name (Legal Business Name): LINDEN PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1368 LINDEN BLVD
BROOKLYN NY
11212-4702
US

IV. Provider business mailing address

PO BOX 120360
BROOKLYN NY
11212-0360
US

V. Phone/Fax

Practice location:
  • Phone: 718-342-3131
  • Fax: 718-569-0073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number027217
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER WILLIAMS
Title or Position: BOOKKEEPER
Credential:
Phone: 718-991-6700