Provider Demographics
NPI:1790261469
Name:SCHULZ, ANDREW L (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:L
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75547 MCKAY RD
Mailing Address - Street 2:
Mailing Address - City:BRUCE TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48065-2713
Mailing Address - Country:US
Mailing Address - Phone:313-310-5020
Mailing Address - Fax:
Practice Address - Street 1:1565 E PIERSON RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1816
Practice Address - Country:US
Practice Address - Phone:810-659-2940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302042141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist