Provider Demographics
NPI:1568798338
Name:LINDHURST PHARMACY SERVICES INC.
Entity Type:Organization
Organization Name:LINDHURST PHARMACY SERVICES INC.
Other - Org Name:LINDHURST PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANANDA
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:BALAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-741-9800
Mailing Address - Street 1:5991 LINDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901
Mailing Address - Country:US
Mailing Address - Phone:530-741-9800
Mailing Address - Fax:530-741-9832
Practice Address - Street 1:5991 LINDHURST AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-9590
Practice Address - Country:US
Practice Address - Phone:530-741-9800
Practice Address - Fax:530-741-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY544843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2165714OtherPK
5636254OtherNCPDP PROVIDER IDENTIFICATION NUMBER