Provider Demographics
NPI:1649873423
Name:SCHULMAN, STUART (RPH)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 INDIGO BAY CIR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-3685
Mailing Address - Country:US
Mailing Address - Phone:908-872-8534
Mailing Address - Fax:
Practice Address - Street 1:2996 E HIGHWAY 501
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9532
Practice Address - Country:US
Practice Address - Phone:843-347-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02045400183500000X
SC1053287183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist