Provider Demographics
NPI:1447724281
Name:SCHAEFER TRUDELL
Entity type:Organization
Organization Name:SCHAEFER TRUDELL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEYDOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-581-2424
Mailing Address - Street 1:5711 SCHAEFER RD STE B
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2290
Mailing Address - Country:US
Mailing Address - Phone:313-581-2424
Mailing Address - Fax:313-581-2193
Practice Address - Street 1:5711 SCHAEFER RD # B
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2290
Practice Address - Country:US
Practice Address - Phone:313-581-2424
Practice Address - Fax:313-581-2193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy