Healthcare Provider Details

I. General information

NPI: 1033862388
Provider Name (Legal Business Name): JOHN SHUNNARAH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 SOUTHCREST TRL
HOOVER AL
35244-5105
US

IV. Provider business mailing address

1612 SOUTHCREST TRL
HOOVER AL
35244-5105
US

V. Phone/Fax

Practice location:
  • Phone: 205-807-3096
  • Fax:
Mailing address:
  • Phone: 205-807-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23612
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: