Provider Demographics
NPI:1356774558
Name:SCHMIDT, ALBERT IV (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:SCHMIDT
Suffix:IV
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4835
Mailing Address - Country:US
Mailing Address - Phone:440-244-1950
Mailing Address - Fax:
Practice Address - Street 1:2709 BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4835
Practice Address - Country:US
Practice Address - Phone:440-244-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist