Provider Demographics
NPI:1932144623
Name:PAUL E SCHROEDER & SCOTT B IHRKE
Entity Type:Organization
Organization Name:PAUL E SCHROEDER & SCOTT B IHRKE
Other - Org Name:DRS. IHRKE & SCHROEDER OR LE MARS OPTOMETRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:IHRKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-546-4183
Mailing Address - Street 1:120 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3508
Mailing Address - Country:US
Mailing Address - Phone:712-546-4183
Mailing Address - Fax:712-548-4101
Practice Address - Street 1:120 1ST ST NW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3508
Practice Address - Country:US
Practice Address - Phone:712-546-4183
Practice Address - Fax:712-548-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01782152W00000X
IA02052152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC8412OtherRR MEDICARE
IA0277150001Medicare NSC
I9434Medicare PIN