Provider Demographics
NPI:1316533599
Name:SCHAMBACH, AUSTIN MARK (RPH)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:MARK
Last Name:SCHAMBACH
Suffix:
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 1:1992 HYDE DR APT K
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-7988
Mailing Address - Country:US
Mailing Address - Phone:304-479-4241
Mailing Address - Fax:
Practice Address - Street 1:1826 E ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5873
Practice Address - Country:US
Practice Address - Phone:252-917-6192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0011759183500000X
NC30799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist