Healthcare Provider Details

I. General information

NPI: 1194097766
Provider Name (Legal Business Name): TODD SCHROEDER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 N SAINT FRANCIS STREET VIA CHRISTI
WICHITA KS
67214
US

IV. Provider business mailing address

918 N CEDAR DOWNS CIR
WICHITA KS
67235-1949
US

V. Phone/Fax

Practice location:
  • Phone: 316-771-8947
  • Fax:
Mailing address:
  • Phone: 316-210-6445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12988
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26019691A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: