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General NPI Number Information
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NPI Number | 1417614033
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Entity Type | Organization
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Legal Business Name | LOFT CHEMISTS LLC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 1184-1186 MAIN STREET
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City | BRIDGEPORT
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State | CT
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Zip | 06604
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Country | US
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Telephone | 203-549-9940
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Fax |
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Provider Business Mailing Address
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Address Line | 1789 FENCE ROW DR
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City | FAIRFIELD
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State | CT
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Zip | 06824-7008
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Country | US
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Telephone | 347-232-1660
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. SHERIHAN SEDRAK
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Credential | PHARM.D.
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Telephone | 347-232-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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