MEDICARE: LINDEN COMMUNITY PHARMACY

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

General Provider Information

NPI Number	:	1083286678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDEN COMMUNITY PHARMACY

Provider Business Mailing Address
First Line	:	1464 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2760
Country	:	US
Telephone Number	:	614-298-4190
Fax Number	:	614-298-4191

Provider Business Practice Location Address
First Line	:	1464 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2760
Country	:	US
Telephone Number	:	614-298-4190
Fax Number	:	614-298-4191

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	SARAH MARIE JONES
Credential	:	PHARMD
Telephone Number	:	330-204-9951

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	07/13/2021

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