Provider Demographics
NPI:1609897636
Name:FREDERICK SCHMID, INC.
Entity Type:Organization
Organization Name:FREDERICK SCHMID, INC.
Other - Org Name:DEXTER PHARMACY 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMID
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:734-426-1600
Mailing Address - Street 1:7039 DEXTER ANN ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-8568
Mailing Address - Country:US
Mailing Address - Phone:734-426-1600
Mailing Address - Fax:734-426-6780
Practice Address - Street 1:7039 DEXTER ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-8568
Practice Address - Country:US
Practice Address - Phone:734-426-1600
Practice Address - Fax:734-426-6780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010071373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2907289Medicaid
MI2361373OtherNABP