Provider Demographics
NPI:1891878211
Name:FALER PHARMACY INC
Entity Type:Organization
Organization Name:FALER PHARMACY INC
Other - Org Name:FALER DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY TECH OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:LIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-793-2445
Mailing Address - Street 1:1806 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602
Mailing Address - Country:US
Mailing Address - Phone:989-793-2445
Mailing Address - Fax:989-797-5534
Practice Address - Street 1:1806 COURT ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602
Practice Address - Country:US
Practice Address - Phone:989-793-2445
Practice Address - Fax:989-797-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010007633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4169160001Medicare ID - Type Unspecified