Provider Demographics
NPI:1013359884
Name:LINDSAY PHARMACY
Entity Type:Organization
Organization Name:LINDSAY PHARMACY
Other - Org Name:LINDSAY MEDICAL PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:EDEM
Authorized Official - Middle Name:T
Authorized Official - Last Name:UDOH-AFAHA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:559-562-7979
Mailing Address - Street 1:PO BOX 21537
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-1537
Mailing Address - Country:US
Mailing Address - Phone:559-562-7979
Mailing Address - Fax:559-671-4300
Practice Address - Street 1:781 SEQUOIA AVE STE 2
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-1448
Practice Address - Country:US
Practice Address - Phone:559-562-7979
Practice Address - Fax:559-671-4300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 51148333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1835G0000XOtherTAXONOMY CODE 1835G0000X
CAPHY 51148OtherCALIFORNIA STATE BOARD OF PHARMACY