Provider Demographics
NPI:1417614033
Name:LOFT CHEMISTS LLC
Entity Type:Organization
Organization Name:LOFT CHEMISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERIHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEDRAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:347-232-1660
Mailing Address - Street 1:1789 FENCE ROW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-7008
Mailing Address - Country:US
Mailing Address - Phone:347-232-1660
Mailing Address - Fax:
Practice Address - Street 1:1184-1186 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604
Practice Address - Country:US
Practice Address - Phone:203-549-9940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy