Provider Demographics
NPI:1396361408
Name:DERMADRY LABORATORIES INC.
Entity Type:Organization
Organization Name:DERMADRY LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLICOEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:514-903-9897
Mailing Address - Street 1:9223 LANGELIER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:ST-LEONARD
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H1P3K9
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9223 LANGELIER BOULEVARD
Practice Address - Street 2:
Practice Address - City:ST-LEONARD
Practice Address - State:QUEBEC
Practice Address - Zip Code:H1P3K9
Practice Address - Country:CA
Practice Address - Phone:514-903-9897
Practice Address - Fax:514-400-6205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies