Individual
JOHN E SHUMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
12000 STONE LAKE RD, DULCE, NM 87528
(575) 759-7250
(575) 159-7250
Mailing address
PO BOX 187, DULCE, NM 87528-0187
(575) 759-7250
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP437949
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000K3526
—
NM
01
—
HSZ196
MEDICARE PART B
NM
Enumeration date
04/27/2007
Last updated
05/28/2008
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