Provider Demographics
NPI:1760768873
Name:SCHROEDER, JAMI JO (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMI JO
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:BROADUS
Mailing Address - State:MT
Mailing Address - Zip Code:59317-0549
Mailing Address - Country:US
Mailing Address - Phone:406-436-2270
Mailing Address - Fax:406-436-2362
Practice Address - Street 1:120 S PARK AVE
Practice Address - Street 2:
Practice Address - City:BROADUS
Practice Address - State:MT
Practice Address - Zip Code:59317
Practice Address - Country:US
Practice Address - Phone:406-436-2270
Practice Address - Fax:406-436-2362
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-02
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY2937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT21507OtherBOARD OF PHARMACY STATE LICENSE
WY2937OtherBOARD OF PHARMACY STATE LICENSE