MEDICARE: LINDHURST PHARMACY SERVICES 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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1588429609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDHURST PHARMACY SERVICES INC

Provider Business Mailing Address
First Line	:	5991 LINDHURST AVE
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6100
Country	:	US
Telephone Number	:	530-741-9800
Fax Number	:	530-741-9832

Provider Business Practice Location Address
First Line	:	5991 LINDHURST AVE
Second Line	:
City	:	MARYSVILLE
State	:	CA
Zip	:	95901-6100
Country	:	US
Telephone Number	:	530-741-9800
Fax Number	:	530-741-9832

Authorized Official
Title or Position	:	CEO
Name	:	MR. ANANDA KUMAR BALAKRISHNAN
Credential	:
Telephone Number	:	530-741-9800

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	09/25/2024

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