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General NPI Number Information
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NPI Number | 1093031577
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Entity Type | Organization
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Legal Business Name | SEIFERT HEALTHCARE LLC
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 100 NORTH ELKHART
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City | WAKARUSA
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State | IN
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Zip | 46573-9305
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Country | US
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Telephone | 574-862-1454
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Fax | 574-862-4923
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Provider Business Mailing Address
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Address Line | PO BOX 425
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City | WAKARUSA
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State | IN
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Zip | 46573-0425
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Country | US
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Telephone | 574-862-1454
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Fax | 574-862-4923
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JEFFREY CLEMENTS
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Credential | PHARMD
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Telephone | 574-295-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 60006218A
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License Number State | IN
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