Provider Demographics
NPI:1790194835
Name:SCHAUWECKER, DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:SCHAUWECKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 EAGLEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-6614
Mailing Address - Country:US
Mailing Address - Phone:541-231-8381
Mailing Address - Fax:
Practice Address - Street 1:476999 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:PONDERAY
Practice Address - State:ID
Practice Address - Zip Code:83852-9738
Practice Address - Country:US
Practice Address - Phone:208-265-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6497183500000X
ORRPH-0010195183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist