Provider Demographics
NPI:1538196217
Name:SCHAFER, RONALD LEON (RP)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:LEON
Last Name:SCHAFER
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 TURTLE BCH
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:NE
Mailing Address - Zip Code:68854-4103
Mailing Address - Country:US
Mailing Address - Phone:308-946-3439
Mailing Address - Fax:
Practice Address - Street 1:1715 26TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-9501
Practice Address - Country:US
Practice Address - Phone:308-946-5981
Practice Address - Fax:308-946-5911
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8634183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist