Provider Demographics
NPI:1902245459
Name:SHULMAN, SAMARA F (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:SAMARA
Middle Name:F
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 GRASS VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-2522
Mailing Address - Country:US
Mailing Address - Phone:530-885-6084
Mailing Address - Fax:
Practice Address - Street 1:2140 GRASS VALLEY HWY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-2522
Practice Address - Country:US
Practice Address - Phone:530-885-6084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist