Provider Demographics
NPI:1699075762
Name:SCHMIDT, THERESA (PHARMD)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:SCHMIDT
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 1:240 NEW BYHALIA RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3716
Mailing Address - Country:US
Mailing Address - Phone:901-853-1331
Mailing Address - Fax:901-854-2711
Practice Address - Street 1:240 NEW BYHALIA RD
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3716
Practice Address - Country:US
Practice Address - Phone:901-853-1331
Practice Address - Fax:901-854-2711
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2010-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist