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General NPI Number Information
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NPI Number | 1801904438
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Entity Type | Organization
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Legal Business Name | DEXTER PRESCRIPTION CENTER INC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 11/07/2020
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Provider Practice Location Address
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Address Line | 1453 JEFFERSON AVE
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City | BUFFALO
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State | NY
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Zip | 14208
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Country | US
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Telephone | 716-885-7878
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Fax | 716-885-4412
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Provider Business Mailing Address
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Address Line | 1453 JEFFERSON AVE
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City | BUFFALO
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State | NY
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Zip | 14208
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Country | US
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Telephone | 716-885-7878
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Fax | 716-885-4412
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DANIEL L REWHART
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Credential | RPH
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Telephone | 716-885-7878
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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 | 017951
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License Number State | NY
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