MEDICARE: DR. DEXTER LAI PHARMD

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	RP445028	PA

General Provider Information

NPI Number	:	1598006058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEXTER LAI PHARMD

Provider Business Mailing Address
First Line	:	5006 BALTIMORE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-3302
Country	:	US
Telephone Number	:	215-748-1000
Fax Number	:	215-748-4715

Provider Business Practice Location Address
First Line	:	5006 BALTIMORE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-3302
Country	:	US
Telephone Number	:	215-748-1000
Fax Number	:	215-748-4715

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

Provider Enumeration Date	:	03/08/2013
Last Update Date	:	03/08/2013

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