Active NPI
Susan Cynthia Lutz, R.PH.
- Pharmacist
- Altoona, IA
National Provider Identifier
1275556839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13504
- Practice address
- 120 8TH St SE
Altoona, IA 50009-1950 - Phone
- (515) 967-4213
- Fax
- (515) 967-3402
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- 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 | 13504 | IA | Primary |
Addresses
Primary practice location
120 8TH St SE
Altoona, IA 50009-1950
Mailing address
120 8TH St SE
Altoona, IA 50009-1950
Phone (515) 967-4213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13504 | Other | IA | PHARMACISTS LICENSE NUMBE |
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 |
|---|---|---|---|
| 13504 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275556839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 8TH ST SE",
"city": "ALTOONA",
"state": "IA",
"postal_code": "500091950",
"telephone_number": "515-967-4213",
"fax_number": "515-967-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 8TH ST SE",
"city": "ALTOONA",
"state": "IA",
"postal_code": "500091950",
"telephone_number": "515-967-4213",
"fax_number": "515-967-3402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "SUSAN",
"middle_name": "CYNTHIA",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "13504",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACISTS LICENSE NUMBE",
"identifier": "13504",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Altoona, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.