Active NPI
Suzy Hackworth, PHARM.D.
- Pharmacist
- San Bernardino, CA
National Provider Identifier
1316487010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57386
- Practice address
- 1717 E Date PL
San Bernardino, CA 92404-4428 - Phone
- (909) 881-4717
- NPI assigned
- Feb 28, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 57386 | CA | Primary |
Addresses
Primary practice location
1717 E Date PL
San Bernardino, CA 92404-4428
Mailing address
11144 Traditions CT
Riverside, CA 92503-5840
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57386 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488240000000",
"number": "1316487010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11144 TRADITIONS CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 E DATE PL",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044428",
"telephone_number": "909-881-4717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKWORTH",
"first_name": "SUZY",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-28",
"last_updated": "2017-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.