Provider Demographics
NPI:1093362923
Name:SCHOMER, PHIL
Entity Type:Individual
Prefix:
First Name:PHIL
Middle Name:
Last Name:SCHOMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1497 NW 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50313-5427
Mailing Address - Country:US
Mailing Address - Phone:515-897-5528
Mailing Address - Fax:
Practice Address - Street 1:1497 NW 66TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50313-5427
Practice Address - Country:US
Practice Address - Phone:515-897-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care