Active NPI
Judith Schroeder
- Pharmacist
- Woodhaven, MI
National Provider Identifier
1417025339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302025964
- Practice address
- 22505 Allen Rd
Woodhaven, MI 48183-2237 - Phone
- (734) 676-7474
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025964 | MI | Primary |
Addresses
Primary practice location
22505 Allen Rd
Woodhaven, MI 48183-2237
Mailing address
2253 20TH St
Wyandotte, MI 48192-4127
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302025964 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417025339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2253 20TH ST",
"city": "WYANDOTTE",
"state": "MI",
"postal_code": "481924127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22505 ALLEN RD",
"city": "WOODHAVEN",
"state": "MI",
"postal_code": "481832237",
"telephone_number": "734-676-7474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHROEDER",
"first_name": "JUDITH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodhaven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.