Active NPI
Robert C Suhovecky, RPH
- Pharmacist
- Fenton, MO
National Provider Identifier
1013291749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 040473
- Practice address
- 1210 Sugar Creek SQ
Fenton, MO 63026-4401 - Phone
- (636) 326-5113
- NPI assigned
- Sep 29, 2011
- Last updated
- Sep 29, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 040473 | MP | Primary |
Addresses
Primary practice location
1210 Sugar Creek SQ
Fenton, MO 63026-4401
Mailing address
1210 Sugar Creek SQ
Fenton, MO 63026-4401
Phone (636) 326-5113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040473 | MP | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1013291749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 SUGAR CREEK SQ",
"city": "FENTON",
"state": "MO",
"postal_code": "630264401",
"telephone_number": "636-326-5113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 SUGAR CREEK SQ",
"city": "FENTON",
"state": "MO",
"postal_code": "630264401",
"telephone_number": "636-326-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUHOVECKY",
"first_name": "ROBERT",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-29",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MP",
"license": "040473",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.