Healthcare Provider Details

I. General information

NPI: 1588961973
Provider Name (Legal Business Name): LARA ANN SCHNEIDER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

2916 LINDEN AVE
DAYTON OH
45410-3027
US

IV. Provider business mailing address

2916 LINDEN AVE
DAYTON OH
45410-3027
US

V. Phone/Fax

Practice location:
  • Phone: 937-256-3111
  • Fax: 937-256-3541
Mailing address:
  • Phone: 937-256-3111
  • Fax: 937-256-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03318494
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: