Healthcare Provider Details

I. General information

NPI: 1831449537
Provider Name (Legal Business Name): AMBER R SCHUMACHER IDMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 5115 BOX MEDICAL
APO AE
09461-5115
US

IV. Provider business mailing address

7135 CARDINAL RD
SPARTA WI
54656
US

V. Phone/Fax

Practice location:
  • Phone: 314-226-8112
  • Fax:
Mailing address:
  • Phone: 701-340-5427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: