MEDICARE: JUSTIN HEDRICH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302040555	MI

General Provider Information

NPI Number	:	1417317272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN HEDRICH

Provider Business Mailing Address
First Line	:	13630 SCHROEDER RD
Second Line	:
City	:	SAINT CHARLES
State	:	MI
Zip	:	48655-9524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3050 BAY RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-2415
Country	:	US
Telephone Number	:	989-792-9606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	03/07/2016

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Directions to “ JUSTIN HEDRICH ” Practice Location

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