Provider Demographics
NPI:1578742813
Name:LIN-KRIS PHARMACY INC
Entity Type:Organization
Organization Name:LIN-KRIS PHARMACY INC
Other - Org Name:HILLSBORO DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-797-3468
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050-0257
Mailing Address - Country:US
Mailing Address - Phone:636-797-3468
Mailing Address - Fax:636-797-5260
Practice Address - Street 1:10666 HWY 21
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:MO
Practice Address - Zip Code:63050-4367
Practice Address - Country:US
Practice Address - Phone:636-797-3346
Practice Address - Fax:636-797-5260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIN-KRIS PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-02
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO620279307Medicaid
MO620279307Medicaid