Provider Demographics
NPI:1639768328
Name:SHUEMAKER, STAN LUCAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:STAN
Middle Name:LUCAS
Last Name:SHUEMAKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 NEW HOLT RD STE D
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-7506
Mailing Address - Country:US
Mailing Address - Phone:270-444-7070
Mailing Address - Fax:270-444-7970
Practice Address - Street 1:3837 CLARKS RIVER RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-0802
Practice Address - Country:US
Practice Address - Phone:270-408-3784
Practice Address - Fax:270-408-3785
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist