Healthcare Provider Details

I. General information

NPI: 1588929160
Provider Name (Legal Business Name): SASCO DEXTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 BAKER RD
DEXTER MI
48130-1181
US

IV. Provider business mailing address

PO BOX 460
DEXTER MI
48130-0460
US

V. Phone/Fax

Practice location:
  • Phone: 734-426-1600
  • Fax: 734-426-6780
Mailing address:
  • Phone: 612-247-6429
  • Fax: 815-642-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009844
License Number StateMI

VIII. Authorized Official

Name: MARNI SCHMID
Title or Position: MEMBER
Credential:
Phone: 612-247-6429