| Organization Name: | SCHNUCK MARKETS INC |
| NPI Number: | 1902832256 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA DOBBS (MGR 3RD PARTY CLAIMS) |
| Mailing Address: | 150 Waterloo Commons Dr Waterloo |
| State: | IL US |
| Postal Code: | 622981081 |
| Phone Number: | 6189393942 |
| Fax Number: | 6189393943 |
| NPI Enumeration Date: | 06/25/2006 |
| NPI Last Update Date: | 08/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 05412055 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |