Provider Demographics
NPI:1679855050
Name:SCHMANSKY, PAUL BERNARD (RPH)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:BERNARD
Last Name:SCHMANSKY
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 1:2036 FOX GLEN CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1006
Mailing Address - Country:US
Mailing Address - Phone:248-334-8186
Mailing Address - Fax:
Practice Address - Street 1:30852 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0920
Practice Address - Country:US
Practice Address - Phone:248-549-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021634183500000X
OH03329024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist