Provider Demographics
NPI:1689980187
Name:SCHUMACHER, JEB S
Entity Type:Individual
Prefix:MR
First Name:JEB
Middle Name:S
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 ALLEN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-3400
Mailing Address - Country:US
Mailing Address - Phone:607-972-9833
Mailing Address - Fax:
Practice Address - Street 1:138 VESTAL PKWY W
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1542
Practice Address - Country:US
Practice Address - Phone:607-748-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054800-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist