Susan P Danielson, RPH
Individual provider Active NPI Pharmacist · Whiting, IN
NPI 1619253085 · NPPES record last updated Oct 28, 2011
Key facts
- NPI
- 1619253085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26015453A (IN)
- Practice address
- 1939 Indianapolis Blvd
Whiting, IN 46394-1509 - Phone
- (219) 659-3541
- Fax
- (219) 473-9124
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26015453A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26015453A | IN | Yes |
Addresses
Primary practice location
1939 Indianapolis Blvd
Whiting, IN 46394-1509
Mailing address
1939 Indianapolis Blvd
Whiting, IN 46394-1509
Phone (219) 659-3541
Other providers in Whiting, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.