Provider Demographics
NPI:1790385714
Name:SCHUELKE, BRANDY (RPH)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SCHUELKE
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 1:418 SANBORN AVE
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-1742
Mailing Address - Country:US
Mailing Address - Phone:567-674-2838
Mailing Address - Fax:
Practice Address - Street 1:4730 ENCORE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-6016
Practice Address - Country:US
Practice Address - Phone:989-772-6302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302045245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist