Provider Demographics
NPI:1437265873
Name:LINDBERG PHARMACY
Entity Type:Organization
Organization Name:LINDBERG PHARMACY
Other - Org Name:JOSE GILBERTO TOVAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:GILBERTO
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-687-6204
Mailing Address - Street 1:5203 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-0231
Mailing Address - Country:US
Mailing Address - Phone:956-687-6204
Mailing Address - Fax:956-687-2244
Practice Address - Street 1:5203 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-0231
Practice Address - Country:US
Practice Address - Phone:956-687-6204
Practice Address - Fax:956-687-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148378OtherVENDOR DRUG ID
TX010717901Medicaid
TX016535901Medicaid
TX016535901Medicaid