Provider Demographics
NPI:1730368077
Name:DEXTER PHARMACY INC
Entity type:Organization
Organization Name:DEXTER PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-426-4641
Mailing Address - Street 1:8059 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-1027
Mailing Address - Country:US
Mailing Address - Phone:734-426-4641
Mailing Address - Fax:734-426-0275
Practice Address - Street 1:8059 MAIN ST
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-1027
Practice Address - Country:US
Practice Address - Phone:734-426-4641
Practice Address - Fax:734-426-0275
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEXTER PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0156270001Medicare NSC