Individual provider Active NPI

Suzanna Grace Vanderver, PHARM. D.

  • Pharmacist
  • North Charleston, SC
National Provider Identifier
1417280694
Registry record updated Sep 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10344 Issued in SC
Practice address
8571 Rivers Ave
North Charleston, SC 29406-9208
Phone
(843) 863-9858
NPI assigned
Sep 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10344 SC Primary

Addresses

Primary practice location

8571 Rivers Ave
North Charleston, SC 29406-9208

Mailing address

3513 E Higgins Dr
Mount Pleasant, SC 29466-6889
Phone (843) 849-0078

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

LicenseStateTypeSpecialty
10344SCMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252195200000",
    "number": "1417280694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 E HIGGINS DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666889",
            "telephone_number": "843-849-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8571 RIVERS AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069208",
            "telephone_number": "843-863-9858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVER",
        "first_name": "SUZANNA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-06",
        "last_updated": "2009-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "10344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.