Provider Demographics
NPI:1033620075
Name:SCHMIT, AMANDA JO (RPH)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:JO
Last Name:SCHMIT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MAIN AVE N
Mailing Address - Street 2:
Mailing Address - City:BAGLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56621-8315
Mailing Address - Country:US
Mailing Address - Phone:218-694-6210
Mailing Address - Fax:
Practice Address - Street 1:31 MAIN AVE N
Practice Address - Street 2:
Practice Address - City:BAGLEY
Practice Address - State:MN
Practice Address - Zip Code:56621-8315
Practice Address - Country:US
Practice Address - Phone:218-694-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist