Active NPI
Susy Kunnody Varughese
- Pharmacist
- Palatka, FL
National Provider Identifier
1487043790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS39181
- Practice address
- 719 S State Road 19
Palatka, FL 32177-3946 - Phone
- (386) 328-6787
- Fax
- (386) 328-8641
- NPI assigned
- Jan 12, 2015
- 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 | PS39181 | FL | Primary |
Addresses
Primary practice location
719 S State Road 19
Palatka, FL 32177-3946
Mailing address
719 S Sr 19
Palatka, FL 32177
Phone (386) 328-6787
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS39181 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1487043790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 S SR 19",
"city": "PALATKA",
"state": "FL",
"postal_code": "32177",
"telephone_number": "386-328-6787",
"fax_number": "386-328-8641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 S STATE ROAD 19",
"city": "PALATKA",
"state": "FL",
"postal_code": "321773946",
"telephone_number": "386-328-6787",
"fax_number": "386-328-8641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARUGHESE",
"first_name": "SUSY",
"middle_name": "KUNNODY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-12",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS39181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.