Provider Demographics
NPI:1235121187
Name:SHUMAN HEALTHCARE SPECIALTY PHARMACY INC.
Entity Type:Organization
Organization Name:SHUMAN HEALTHCARE SPECIALTY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:912-285-1619
Mailing Address - Street 1:2011 TEBEAU ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-6358
Mailing Address - Country:US
Mailing Address - Phone:912-285-1619
Mailing Address - Fax:912-285-4470
Practice Address - Street 1:2011 TEBEAU ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-6358
Practice Address - Country:US
Practice Address - Phone:912-285-1619
Practice Address - Fax:912-285-4470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000479971AMedicaid
GA000479971BMedicaid
GA000479971BMedicaid