Provider Demographics
NPI:1619209830
Name:SCHOMAKER, JACQUELINE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:SCHOMAKER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19B PATTEN RD
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:ME
Mailing Address - Zip Code:04236-3964
Mailing Address - Country:US
Mailing Address - Phone:207-946-2425
Mailing Address - Fax:207-946-2428
Practice Address - Street 1:19B PATTEN ROAD
Practice Address - Street 2:
Practice Address - City:GREENE
Practice Address - State:ME
Practice Address - Zip Code:04236
Practice Address - Country:US
Practice Address - Phone:207-946-2425
Practice Address - Fax:207-946-2425
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR4456183500000X
MA21906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist