Provider Demographics
NPI:1962793711
Name:SCHNEIDER, MICHAEL ANDREW (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANDREW
Last Name:SCHNEIDER
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 1:308 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-1735
Mailing Address - Country:US
Mailing Address - Phone:606-337-8300
Mailing Address - Fax:606-337-8398
Practice Address - Street 1:308 S PINE ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1735
Practice Address - Country:US
Practice Address - Phone:606-337-8300
Practice Address - Fax:606-337-8398
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist