Provider Demographics
NPI:1104826981
Name:SHUMET INC
Entity Type:Organization
Organization Name:SHUMET INC
Other - Org Name:KEANSBURG DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:732-787-1414
Mailing Address - Street 1:199 MAIN ST
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:KEANSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07734-1768
Mailing Address - Country:US
Mailing Address - Phone:732-787-1414
Mailing Address - Fax:732-495-5590
Practice Address - Street 1:199 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-1768
Practice Address - Country:US
Practice Address - Phone:732-787-1414
Practice Address - Fax:732-495-5590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS003642003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2054700OtherPK
NJ4362004Medicaid
0527540001Medicare NSC