Provider Demographics
NPI:1093949216
Name:LIN-KRIS PHARMACY INC
Entity Type:Organization
Organization Name:LIN-KRIS PHARMACY INC
Other - Org Name:EBERHART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:H
Authorized Official - Last Name:EBERHART
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:314-638-1000
Mailing Address - Street 1:4221 BAYLESS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7513
Mailing Address - Country:US
Mailing Address - Phone:314-638-1000
Mailing Address - Fax:314-638-8430
Practice Address - Street 1:4221 BAYLESS AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7513
Practice Address - Country:US
Practice Address - Phone:314-638-1000
Practice Address - Fax:314-638-8430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0151970001Medicare NSC