Provider Demographics
NPI:1376189738
Name:SCHMIDT, CAROLYN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:ECHELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:18 STAUNTON WAY
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8544
Mailing Address - Country:US
Mailing Address - Phone:636-627-8127
Mailing Address - Fax:
Practice Address - Street 1:1 TROY SQ
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MO
Practice Address - Zip Code:63379-3101
Practice Address - Country:US
Practice Address - Phone:636-462-1251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010025186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist