Provider Demographics
NPI:1689879017
Name:SCHULMAN, GLENN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:
Last Name:SCHULMAN
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 1:3585 CHASTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4467
Mailing Address - Country:US
Mailing Address - Phone:850-438-5269
Mailing Address - Fax:850-494-3352
Practice Address - Street 1:3585 CHASTAIN WAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4467
Practice Address - Country:US
Practice Address - Phone:850-438-5269
Practice Address - Fax:850-494-3352
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-16
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist