Active NPI
Suzanne Grimm
- Pharmacist
- Hudson, OH
National Provider Identifier
1679156509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03223648
- Practice address
- 116 W Streetsboro St
Hudson, OH 44236-2738 - Phone
- (330) 650-1608
- Fax
- (330) 656-3327
- NPI assigned
- Apr 29, 2021
- Last updated
- Apr 29, 2021
- 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 | 03223648 | OH | Primary |
Addresses
Primary practice location
116 W Streetsboro St
Hudson, OH 44236-2738
Mailing address
116 W Streetsboro St
Hudson, OH 44236-2738
Phone (330) 650-1608
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NONE | Other | NONE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | N/a | Other |
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 |
|---|---|---|---|
| 03223648 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred W Albrecht Grocery Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1679156509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 W STREETSBORO ST",
"city": "HUDSON",
"state": "OH",
"postal_code": "442362738",
"telephone_number": "330-650-1608",
"fax_number": "330-656-3327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 W STREETSBORO ST",
"city": "HUDSON",
"state": "OH",
"postal_code": "442362738",
"telephone_number": "330-650-1608",
"fax_number": "330-656-3327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "SUZANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03223648",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NONE",
"identifier": "NONE",
"state": null
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "N/a",
"affiliation": "N",
"endpointDescription": "N/a",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "N/a",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "N/a",
"address_1": "116 W Streetsboro St",
"city": "Hudson",
"state": "OH",
"country_code": "US",
"postal_code": "442362738",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hudson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.