NPIMap

Organization Active NPI

Professional Pharmacy

Doing business as Dexter Health Services

  • Durable Medical Equipment & Medical Supplies
  • Logansport, IN
National Provider Identifier
1003802927
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
69000792A Issued in IN
Legal business name
PROFESSIONAL PHARMACY
Doing business as
Dexter Health Services
Practice address
800 Fulton St
Logansport, IN 46947-1577
Phone
(574) 722-5678
Fax
(574) 753-5597
NPI assigned
Sep 26, 2005
Last updated
Jun 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christine Farnham, RPHNPI 1609862549
Title
Corp Secretary Treasurer
Phone
(574) 722-5678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 69000792A IN Primary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

800 Fulton St
Logansport, IN 46947-1577

Mailing address

800 Fulton St
Logansport, IN 46947-1577
Phone (574) 722-5678

Other identifiers 2

IdentifierTypeStateIssuer
100175590MedicaidIN
1518616OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • DEXTER HEALTH SERVICES Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338508800000",
    "number": "1003802927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FULTON ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471577",
            "telephone_number": "574-722-5678",
            "fax_number": "574-753-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FULTON ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471577",
            "telephone_number": "574-722-5678",
            "fax_number": "574-753-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-06-01",
        "status": "A",
        "authorized_official_last_name": "FARNHAM",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CORP SECRETARY TREASURER",
        "authorized_official_telephone_number": "574-722-5678",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000792A",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100175590",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1518616",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEXTER HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.