Provider Demographics
NPI:1780973537
Name:SCHUTZ, NICHOLAS (PHARMD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:SCHUTZ
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 1:851 MARKETPLACE DRIVE
Mailing Address - Street 2:BECK PHARMACY
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-1548
Mailing Address - Country:US
Mailing Address - Phone:952-442-2512
Mailing Address - Fax:952-442-5787
Practice Address - Street 1:851 MARKETPLACE DRIVE
Practice Address - Street 2:BECK PHARMACY
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1548
Practice Address - Country:US
Practice Address - Phone:952-442-2512
Practice Address - Fax:952-442-5787
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist