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General NPI Number Information
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NPI Number | 1568992857
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Entity Type | Organization
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Legal Business Name | LINDENWOOD RX, INC
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 10/16/2019
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Provider Practice Location Address
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Address Line | 1860 MOWRY AVENUEW SUITE 102
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City | FREMONT
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State | CA
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Zip | 94538-0300
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Country | US
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Telephone | 510-509-2123
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Fax | 510-358-2662
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Provider Business Mailing Address
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Address Line | 1860 MOWRY AVENUEW SUITE 102
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City | FREMONT
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State | CA
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Zip | 94538-0300
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Country | US
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Telephone | 510-509-2123
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Fax | 510-358-2662
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Authorized Official
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Title or Position | OFFICER
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Name | MR. ARSEN GALSTYAN
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Credential |
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Telephone | 510-509-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 56823
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License Number State | CA
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