Provider Demographics
NPI:1730231572
Name:SCHLIEM, PHILLIP D (RPH)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:D
Last Name:SCHLIEM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11008 QUINN AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3234
Mailing Address - Country:US
Mailing Address - Phone:952-888-6059
Mailing Address - Fax:
Practice Address - Street 1:509 W 98TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-4713
Practice Address - Country:US
Practice Address - Phone:952-884-7528
Practice Address - Fax:952-884-6366
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111750-7183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist