Provider Demographics
NPI:1861604100
Name:SCHMITZ, TARA MAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:MAE
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:OAKES
Mailing Address - State:ND
Mailing Address - Zip Code:58474-2312
Mailing Address - Country:US
Mailing Address - Phone:701-742-2622
Mailing Address - Fax:
Practice Address - Street 1:610 MAIN AVE
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-1639
Practice Address - Country:US
Practice Address - Phone:701-742-3824
Practice Address - Fax:701-742-4564
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDPHARMACY LICENSE NUMOther4586