Healthcare Provider Details

I. General information

NPI: 1366628737
Provider Name (Legal Business Name): PETER ERICK SCHULTZ PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 GREENWAY CT
BOZEMAN MT
59718-1837
US

IV. Provider business mailing address

357 GREENWAY CT
BOZEMAN MT
59718-1837
US

V. Phone/Fax

Practice location:
  • Phone: 406-624-6727
  • Fax:
Mailing address:
  • Phone: 406-624-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5317
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number5317
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number5317
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: