Healthcare Provider Details

I. General information

NPI: 1508152380
Provider Name (Legal Business Name): TALLIE SCHNEIDER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 HIGHWAY 2 E STE 101
RUGBY ND
58368-7801
US

IV. Provider business mailing address

800 S MAIN AVE
RUGBY ND
58368-2118
US

V. Phone/Fax

Practice location:
  • Phone: 701-776-2531
  • Fax: 701-776-5448
Mailing address:
  • Phone: 701-776-5455
  • Fax: 701-776-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5379
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: