Provider Demographics
NPI:1972778702
Name:SCHULTZ, MICHELLE PAULA (RPH)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PAULA
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S VINE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:PA
Mailing Address - Zip Code:17851-2040
Mailing Address - Country:US
Mailing Address - Phone:570-339-1656
Mailing Address - Fax:
Practice Address - Street 1:3300 ROUTE 61 SOUTH
Practice Address - Street 2:
Practice Address - City:COAL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:17866
Practice Address - Country:US
Practice Address - Phone:570-648-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038006L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist