Provider Demographics
NPI:1043391139
Name:LINGER ENTERPRISES, INC.
Entity Type:Organization
Organization Name:LINGER ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER , RPH
Authorized Official - Prefix:
Authorized Official - First Name:BIJALKUMAR
Authorized Official - Middle Name:JAYANTILAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-863-3784
Mailing Address - Street 1:705 SOUTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-1164
Mailing Address - Country:US
Mailing Address - Phone:502-863-9823
Mailing Address - Fax:
Practice Address - Street 1:705 SOUTH BROADWAY
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-1164
Practice Address - Country:US
Practice Address - Phone:502-863-9823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP079423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1815224OtherNABP NUMBER
KY54018163Medicaid