Provider Demographics
NPI:1922051390
Name:SCHULTZ, DONNA L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:L
Last Name:SCHULTZ
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 1:433 SOVEREIGN CT
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-4432
Mailing Address - Country:US
Mailing Address - Phone:314-996-3952
Mailing Address - Fax:314-996-3956
Practice Address - Street 1:433 SOVEREIGN CT
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4432
Practice Address - Country:US
Practice Address - Phone:314-996-3952
Practice Address - Fax:314-996-3956
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999138361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist