Provider Demographics
NPI:1750424602
Name:MUNSTER MEDICAL CENTER INFUSION PRODUCTS, INC.
Entity type:Organization
Organization Name:MUNSTER MEDICAL CENTER INFUSION PRODUCTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:A
Authorized Official - Last Name:STEMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-1899
Mailing Address - Street 1:757 - 45TH STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2912
Mailing Address - Country:US
Mailing Address - Phone:219-836-1899
Mailing Address - Fax:219-836-2464
Practice Address - Street 1:757 - 45TH STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2912
Practice Address - Country:US
Practice Address - Phone:219-836-1899
Practice Address - Fax:219-836-2464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60005454A332B00000X, 3336C0003X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200254070AMedicaid
IN000000107804OtherANTHEM PROVIDER NUMBER
IN000000107804OtherANTHEM PROVIDER NUMBER