Provider Demographics
NPI:1164656385
Name:LIN-KRIS PHARMACY INC
Entity Type:Organization
Organization Name:LIN-KRIS PHARMACY INC
Other - Org Name:WESTLAND 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:636-337-1761
Mailing Address - Street 1:2060 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-1052
Mailing Address - Country:US
Mailing Address - Phone:636-337-1761
Mailing Address - Fax:636-586-0007
Practice Address - Street 1:2060 ROCK RD
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-1052
Practice Address - Country:US
Practice Address - Phone:636-337-1761
Practice Address - Fax:636-586-0007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIN-KRIS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0151970004Medicare NSC