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NPI Code Detail

MEDICARE: LIN KRIS PHARMACY INC

MEDICARE: LIN KRIS PHARMACY 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
13336C0003XCommunity/Retail Pharmacy2002005822MO

Other Identifiers

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

General Provider Information

NPI Number : 1891712659
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIN KRIS PHARMACY INC
Provider Business Mailing Address
First Line : 4642 HOUSE SPRINGS CTR
Second Line :
City : HOUSE SPRINGS
State : MO
Zip : 63051-1376
Country : US
Telephone Number : 636-671-4600
Fax Number : 636-671-3388
Provider Business Practice Location Address
First Line : 4642 HOUSE SPRINGS CTR
Second Line :
City : HOUSE SPRINGS
State : MO
Zip : 63051-1376
Country : US
Telephone Number : 636-671-4600
Fax Number : 636-671-3388
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MR. ROY H EBERHART II
Credential : R.PH
Telephone Number : 636-671-4600
Provider Enumeration Date : 07/17/2006
Last Update Date : 06/18/2008

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