Individual provider Active NPI

Eric M. Schladebeck, PHARM D.

  • Pharmacist
  • Spencerport, NY
National Provider Identifier
1013194125
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0516171 Issued in NY
Practice address
42 Nichols St
Suite 11
Spencerport, NY 14559-2180
Phone
(585) 349-3562
Fax
(585) 349-3564
NPI assigned
Jan 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0516171 NY Primary

Addresses

Primary practice location

42 Nichols St
Suite 11
Spencerport, NY 14559-2180

Mailing address

42 Nichols St
Suite 11
Spencerport, NY 14559-2180
Phone (585) 349-3562

Other identifiers 1

IdentifierTypeStateIssuer
02917917MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0516171NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Spencerport Family Apothecary, LLC Current Accepting new patients

Locations

42 Nichols St
Ste 11
Spencerport, NY 14559
Phone (585) 349-3562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1013194125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NICHOLS ST",
            "address_2": "SUITE 11",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592180",
            "telephone_number": "585-349-3562",
            "fax_number": "585-349-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NICHOLS ST",
            "address_2": "SUITE 11",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592180",
            "telephone_number": "585-349-3562",
            "fax_number": "585-349-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLADEBECK",
        "first_name": "ERIC",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0516171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02917917",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencerport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.