Active NPI
Suganthi Debrito, RPH
- Pharmacist
- Saddlebrooke, MO
National Provider Identifier
1477839439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044174
- Practice address
- 100 Buckskin Gap
Saddlebrooke, MO 65630-3053 - Phone
- (417) 587-4550
- NPI assigned
- Oct 22, 2011
- Last updated
- Oct 22, 2011
- 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 | 044174 | MO | Primary |
Addresses
Primary practice location
100 Buckskin Gap
Saddlebrooke, MO 65630-3053
Mailing address
100 Buckskin Gap
Saddlebrooke, MO 65630-3053
Phone (417) 587-4550
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 |
|---|---|---|---|
| 044174 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319241600000",
"number": "1477839439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 BUCKSKIN GAP",
"city": "SADDLEBROOKE",
"state": "MO",
"postal_code": "656303053",
"telephone_number": "417-587-4550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BUCKSKIN GAP",
"city": "SADDLEBROOKE",
"state": "MO",
"postal_code": "656303053",
"telephone_number": "417-587-4550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRITO",
"first_name": "SUGANTHI",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-22",
"last_updated": "2011-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.