Provider Demographics
NPI:1790960458
Name:LINDEN CARE LLC
Entity Type:Organization
Organization Name:LINDEN CARE LLC
Other - Org Name:LINDEN CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-308-4336
Mailing Address - Street 1:130 CROSSWAYS PARK DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2046
Mailing Address - Country:US
Mailing Address - Phone:516-221-7600
Mailing Address - Fax:516-308-4339
Practice Address - Street 1:130 CROSSWAYS PARK DR
Practice Address - Street 2:SUITE 101
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2046
Practice Address - Country:US
Practice Address - Phone:516-221-7600
Practice Address - Fax:516-308-4339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYNY18493336C0003X
IN6400146A3336C0003X
GAPHNR0002453336C0003X
FLPH250153336C0003X
AKPHAO14493336C0003X
IA41423336C0003X
DCNRX00004893336C0003X
CTPCN.00022143336C0003X
LAPHY.006745-NR3336C0003X
KS22-445523336C0003X
COOSP.00059493336C0003X
IL0540183023336C0003X
AZY0056783336C0003X
DEA9-00012903336C0003X
ID37114MS3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2070134OtherPK
2070134OtherPK
6299960001Medicare NSC