Provider Demographics
NPI:1437448040
Name:SCHROEDER, NELSON R (RPH)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:R
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 N 5TH ST
Mailing Address - Street 2:RITE AID 11171
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-2450
Mailing Address - Country:US
Mailing Address - Phone:610-929-9775
Mailing Address - Fax:610-939-9930
Practice Address - Street 1:3215 N 5TH ST
Practice Address - Street 2:RITE AID 11171
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-2450
Practice Address - Country:US
Practice Address - Phone:610-929-9775
Practice Address - Fax:610-939-9930
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031325L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist