Healthcare Provider Details

I. General information

NPI: 1205994506
Provider Name (Legal Business Name): BARRY SCHULMAN R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W209N17321 INDUSTRIAL DR
JACKSON WI
53037-9389
US

IV. Provider business mailing address

5147 W WOODLAND DR
MILWAUKEE WI
53223-1331
US

V. Phone/Fax

Practice location:
  • Phone: 262-677-1401
  • Fax: 262-677-9112
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10011
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: