Individual provider Active NPI

Susan Lee Sullivan, RPH

  • Pharmacist
  • Rehoboth Beach, DE
National Provider Identifier
1639479710
Registry record updated Oct 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A1-0003356 Issued in DE
Practice address
19266 Coastal Hwy
Rehoboth Beach, DE 19971-6117
Phone
(302) 226-8410
Fax
(302) 226-8461
NPI assigned
Oct 24, 2010
Last updated
Oct 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X A1-0003356 DE Primary

Addresses

Primary practice location

19266 Coastal Hwy
Rehoboth Beach, DE 19971-6117

Mailing address

19266 Coastal Hwy
Rehoboth Beach, DE 19971-6117
Phone (302) 226-8410

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

LicenseStateTypeSpecialty
A1-0003356DEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1287878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287878400000",
    "number": "1639479710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19266 COASTAL HWY",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199716117",
            "telephone_number": "302-226-8410",
            "fax_number": "302-226-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19266 COASTAL HWY",
            "city": "REHOBOTH BEACH",
            "state": "DE",
            "postal_code": "199716117",
            "telephone_number": "302-226-8410",
            "fax_number": "302-226-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-24",
        "last_updated": "2010-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0003356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rehoboth Beach, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2010; 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.