Healthcare Provider Details

I. General information

NPI: 1073505186
Provider Name (Legal Business Name): SHUMAN HEALTHCARE BRUNSWICK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 ALTAMA AVE
BRUNSWICK GA
31520-4608
US

IV. Provider business mailing address

2013 TEBEAU ST
WAYCROSS GA
31501-6358
US

V. Phone/Fax

Practice location:
  • Phone: 912-264-8034
  • Fax: 912-264-4151
Mailing address:
  • Phone: 912-264-8034
  • Fax: 912-264-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ROY M SHUMAN
Title or Position: OWNER/CEO
Credential: RPH
Phone: 912-285-5272