Provider Demographics
NPI:1720304959
Name:SCHREINER, EDWARD R JR (RPH)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:R
Last Name:SCHREINER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 GROVE ST
Mailing Address - Street 2:STOLL'S PHARMACY, INC.
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06710-2289
Mailing Address - Country:US
Mailing Address - Phone:203-575-0199
Mailing Address - Fax:203-575-0515
Practice Address - Street 1:185 GROVE ST
Practice Address - Street 2:STOLL'S PHARMACY, INC.
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06710-2289
Practice Address - Country:US
Practice Address - Phone:203-575-0199
Practice Address - Fax:203-575-0515
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0005974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist