Provider Demographics
NPI:1154696904
Name:SHUNNARAH, JOSEPH SAID (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:SAID
Last Name:SHUNNARAH
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 1:15350 PEPPER CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-7403
Mailing Address - Country:US
Mailing Address - Phone:256-230-6912
Mailing Address - Fax:
Practice Address - Street 1:27691 CAPSHAW ROAD
Practice Address - Street 2:
Practice Address - City:HARVEST
Practice Address - State:AL
Practice Address - Zip Code:35749-7403
Practice Address - Country:US
Practice Address - Phone:256-230-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist