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General NPI Number Information
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NPI Number | 1518674951
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Entity Type | Organization
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Legal Business Name | DEXTER MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 1132 THERESA DR
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1545
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Country | US
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Telephone | 614-915-8324
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Fax |
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Provider Business Mailing Address
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Address Line | 1132 THERESA DR
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1545
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Country | US
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Telephone | 614-915-8324
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. THOMAS L DEXTER III
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Credential | PA-C
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Telephone | 614-915-8324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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