NPIMap

Organization Active NPI

Lin-Kris Pharmacy Inc

Doing business as Eberhart Pharmacy

  • Community/Retail Pharmacy
  • Saint Louis, MO
National Provider Identifier
1578580304
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
003766 Issued in MO
Legal business name
LIN-KRIS PHARMACY INC
Doing business as
Eberhart Pharmacy
Practice address
4221 Bayless Ave
Saint Louis, MO 63123-7513
Phone
(314) 638-1000
Fax
(314) 638-8430
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roy Eberhart, RPH
Title
Pres Owner
Phone
(314) 795-8426

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 003766 MO Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

4221 Bayless Ave
Saint Louis, MO 63123-7513

Mailing address

4221 Bayless Ave
Saint Louis, MO 63123-7513
Phone (314) 638-1000

Other identifiers 2

IdentifierTypeStateIssuer
600128300MedicaidMO
2051554OtherPK

Other names 1

  • EBERHART PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000259 MO Part B Supplier - Mass Immunization (Roster Biller Only) 5193626588 3 other NPIs on this enrollment
Practice locations: Cedar Hill, MO; De Soto, MO; Hillsboro, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433116800000",
    "number": "1578580304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237513",
            "telephone_number": "314-638-1000",
            "fax_number": "314-638-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4221 BAYLESS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237513",
            "telephone_number": "314-638-1000",
            "fax_number": "314-638-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIN-KRIS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-06-01",
        "status": "A",
        "authorized_official_last_name": "EBERHART",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "PRES OWNER",
        "authorized_official_telephone_number": "314-795-8426",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "003766",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600128300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2051554",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EBERHART PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.