Provider Demographics
NPI:1649550328
Name:SCHULZ, LAURA JO (RPH)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JO
Last Name:SCHULZ
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 1:5060 TOWNSHIP ROAD 56
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43324-9773
Mailing Address - Country:US
Mailing Address - Phone:419-226-9025
Mailing Address - Fax:419-226-9866
Practice Address - Street 1:730 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4602
Practice Address - Country:US
Practice Address - Phone:419-226-9025
Practice Address - Fax:419-226-9866
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist