Provider Demographics
NPI:1922287267
Name:DEXTER PHARMACY INC
Entity Type:Organization
Organization Name:DEXTER PHARMACY INC
Other - Org Name:VILLAGE PHARMACY II
Other - Org Type:Doing Business As
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:734-668-9600
Mailing Address - Street 1:325 N MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2824
Mailing Address - Country:US
Mailing Address - Phone:734-668-9600
Mailing Address - Fax:734-668-9218
Practice Address - Street 1:325 N MAPLE RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2824
Practice Address - Country:US
Practice Address - Phone:734-668-9600
Practice Address - Fax:734-668-9218
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
0156270002Medicare NSC