Provider Demographics
NPI:1851566814
Name:SCHROEDER WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:SCHROEDER WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TALETTE
Authorized Official - Middle Name:DEDREE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-856-7600
Mailing Address - Street 1:1820 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1709
Mailing Address - Country:US
Mailing Address - Phone:785-856-7600
Mailing Address - Fax:785-856-7511
Practice Address - Street 1:1820 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1709
Practice Address - Country:US
Practice Address - Phone:785-856-7600
Practice Address - Fax:785-856-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4076111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062011Medicare PIN
KSU29013Medicare UPIN