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A pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nuclear Pharmacy |
3336N0007X | 58 | Medical Supply Company with Pharmacist | |
Community/Retail Pharmacy |
3336C0003X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1619058468 |
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| LBN Legal business name | LINE AVENUE PHARMACY INC | ||||||||||||
| Authorized official | STEPHEN CAUDLE - (PRESIDENT/OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 10/18/2006 | ||||||||||||
| Last updated | 09/11/2025 - About 9 months ago | ||||||||||||
| Identifiers |
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LINE AVENUE PHARMACY INC