Provider Demographics
NPI:1225168180
Name:SCHALDECKER, TERRY LYNN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:LYNN
Last Name:SCHALDECKER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 ROAD 5
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:NE
Mailing Address - Zip Code:68365
Mailing Address - Country:US
Mailing Address - Phone:402-366-0477
Mailing Address - Fax:
Practice Address - Street 1:120 PARK AVE
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:NE
Practice Address - Zip Code:68370
Practice Address - Country:US
Practice Address - Phone:402-768-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9854183500000X
KS9900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist