Provider Demographics
NPI:1801506316
Name:LINDERUD APOTHECARIES LLC
Entity type:Organization
Organization Name:LINDERUD APOTHECARIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDERUD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:715-784-0262
Mailing Address - Street 1:PO BOX 437
Mailing Address - Street 2:
Mailing Address - City:THREE LAKES
Mailing Address - State:WI
Mailing Address - Zip Code:54562-0437
Mailing Address - Country:US
Mailing Address - Phone:715-546-3266
Mailing Address - Fax:
Practice Address - Street 1:1790 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:THREE LAKES
Practice Address - State:WI
Practice Address - Zip Code:54562-9046
Practice Address - Country:US
Practice Address - Phone:715-546-3266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-25
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy