Provider Demographics
NPI:1417031089
Name:SCHUCHMANNS' PHARMACY, INC.
Entity Type:Organization
Organization Name:SCHUCHMANNS' PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUCHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:319-283-2161
Mailing Address - Street 1:12 S FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-2305
Mailing Address - Country:US
Mailing Address - Phone:319-283-2161
Mailing Address - Fax:319-283-3926
Practice Address - Street 1:12 S FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-2305
Practice Address - Country:US
Practice Address - Phone:319-283-2161
Practice Address - Fax:319-283-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0017889Medicaid
IA1219320001Medicare ID - Type Unspecified