MEDICARE: AM SCHNEIDER PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	263462	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2128115	OTHER		PK

General Provider Information

NPI Number	:	1497743454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AM SCHNEIDER PA

Provider Business Mailing Address
First Line	:	242 CLEVELAND AVE S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55105-1242
Country	:	US
Telephone Number	:	651-698-0825
Fax Number	:	651-698-6232

Provider Business Practice Location Address
First Line	:	357 QUAIL ST
Second Line	:
City	:	MAHTOMEDI
State	:	MN
Zip	:	55115-1455
Country	:	US
Telephone Number	:	612-221-8189
Fax Number	:	651-698-6232

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ANNE SCHNEIDER
Credential	:
Telephone Number	:	651-698-0825

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	02/14/2017

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Directions to “AM SCHNEIDER PA ” Practice Location

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