Healthcare Provider Details

I. General information

NPI: 1588758999
Provider Name (Legal Business Name): LARRY C SCHIEBER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 LANCASTER PIKE
CIRCLEVILLE OH
43113-1507
US

IV. Provider business mailing address

212 LANCASTER PIKE
CIRCLEVILLE OH
43113-1507
US

V. Phone/Fax

Practice location:
  • Phone: 740-474-1971
  • Fax: 740-474-1971
Mailing address:
  • Phone: 740-474-1971
  • Fax: 740-474-3689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020574600
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARRY SCHIEBER
Title or Position: OWNER
Credential: BACHELORS
Phone: 740-474-1971