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General NPI Number Information
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NPI Number | 1205106101
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Entity Type | Individual
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Provider Name | JERAD CHARLES SCHEMMEL
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Gender | Male
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 55 JFK RD
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City | DUBUQUE
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State | IA
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Zip | 52002-5309
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Country | US
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Telephone | 563-556-3705
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Fax |
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Provider Business Mailing Address
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Address Line | 3339 BROOK MEADOW CT
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City | DUBUQUE
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State | IA
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Zip | 52002-2346
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Country | US
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Telephone | 563-588-6279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18483
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License Number State | IA
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