Healthcare Provider Details

I. General information

NPI: 1134555766
Provider Name (Legal Business Name): CAMERON T SCHULTE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2013
Last Update Date: 09/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 E HIGH ST
JEFFERSON CITY MO
65101-3207
US

IV. Provider business mailing address

226 E HIGH ST
JEFFERSON CITY MO
65101-3207
US

V. Phone/Fax

Practice location:
  • Phone: 573-636-4022
  • Fax:
Mailing address:
  • Phone: 573-636-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2013026471
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: