Provider Demographics
NPI:1366628737
Name:SCHULTZ, PETER ERICK (PHARM D)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:ERICK
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 GREENWAY CT
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-1837
Mailing Address - Country:US
Mailing Address - Phone:406-624-6727
Mailing Address - Fax:
Practice Address - Street 1:357 GREENWAY CT
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-1837
Practice Address - Country:US
Practice Address - Phone:406-624-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5317183500000X, 1835G0303X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No1835X0200XPharmacy Service ProvidersPharmacistOncology