Provider Demographics
NPI:1568577591
Name:LINTON PHARMACY INC
Entity Type:Organization
Organization Name:LINTON PHARMACY INC
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-792-3030
Mailing Address - Street 1:1000 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-4208
Mailing Address - Country:US
Mailing Address - Phone:620-792-3030
Mailing Address - Fax:620-792-4971
Practice Address - Street 1:1000 ADAMS ST
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4208
Practice Address - Country:US
Practice Address - Phone:620-792-3030
Practice Address - Fax:620-792-4971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2009-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
KS2096933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1714725OtherNCPDP PROVIDER IDENTIFICATION NUMBER
KS100439780AMedicaid
KS100439780BMedicaid
KS0473710001Medicare NSC