MEDICARE: JUSTIN SCHNEWEIS

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	183500000X	Pharmacist	16899	KS

General Provider Information

NPI Number	:	1700252863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN SCHNEWEIS

Provider Business Mailing Address
First Line	:	2900 S 9TH ST
Second Line	:
City	:	SALINA
State	:	KS
Zip	:	67401-7879
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1624 NE 110 AVE
Second Line	:
City	:	CLAFLIN
State	:	KS
Zip	:	67525-9195
Country	:	US
Telephone Number	:	620-282-0734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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