Provider Demographics
NPI:1447353560
Name:LINTON DRUG COMPANY
Entity type:Organization
Organization Name:LINTON DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-254-5432
Mailing Address - Street 1:121 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LINTON
Mailing Address - State:ND
Mailing Address - Zip Code:58552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 BROADWAY
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:ND
Practice Address - Zip Code:58552
Practice Address - Country:US
Practice Address - Phone:701-254-5432
Practice Address - Fax:701-254-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND93333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3501219OtherOTHER ID NUMBER-COMMERCIAL NUMBER
ND20951Medicaid
3501219OtherOTHER ID NUMBER-COMMERCIAL NUMBER