Provider Demographics
NPI:1194097766
Name:SCHROEDER, TODD (PHARMD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 N CEDAR DOWNS CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67235-1949
Mailing Address - Country:US
Mailing Address - Phone:316-210-6445
Mailing Address - Fax:
Practice Address - Street 1:929 N SAINT FRANCIS STREET
Practice Address - Street 2:VIA CHRISTI
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214
Practice Address - Country:US
Practice Address - Phone:316-771-8947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS129881835P0018X
IN26019691A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist