Provider Demographics
NPI:1225733868
Name:SCHORR, RUSSELL W SR
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:W
Last Name:SCHORR
Suffix:SR
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 1:5107 M ST NE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:OH
Mailing Address - Zip Code:44643-8462
Mailing Address - Country:US
Mailing Address - Phone:234-410-6353
Mailing Address - Fax:
Practice Address - Street 1:5107 M ST NE
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:OH
Practice Address - Zip Code:44643-8462
Practice Address - Country:US
Practice Address - Phone:234-410-6353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)