Basic Information
| Provider Information | |||||||||
| NPI: | 1023427671 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDENMEYER | ||||||||
| FirstName: | DANIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1410 S KANSAS AVE | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671145302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162843725 | ||||||||
| FaxNumber: | 3162843728 | ||||||||
| Practice Location | |||||||||
| Address1: | 1410 S KANSAS AVE | ||||||||
| Address2: | |||||||||
| City: | NEWTON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 671145302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162843725 | ||||||||
| FaxNumber: | 3162843728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2014 | ||||||||
| LastUpdateDate: | 08/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 1-12145 | KS | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.