Active NPI
Suzanne Bristow-Marcalus, RPH
- Pharmacist
- Berlin, MD
National Provider Identifier
1790905271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11206
- Practice address
- 10231 Old Ocean City Blvd
Ste 103, James G. Barrett Medical BLDG
Berlin, MD 21811 - Phone
- (410) 629-0071
- Fax
- (410) 629-0081
- NPI assigned
- Apr 26, 2007
- Last updated
- Jul 8, 2007
- 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 | 11206 | MD | Primary |
Addresses
Primary practice location
10231 Old Ocean City Blvd
Ste 103, James G. Barrett Medical BLDG
Berlin, MD 21811
Mailing address
12312 Savanna CT
Bishopville, MD 21813-1686
Phone (410) 352-3664
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 |
|---|---|---|---|
| 11206 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oc Pharma, Inc | Pharmacist | Past | Accepting new patients |
| A V P Pharma Inc | Past | Accepting new patients |
Organizations & group practices 2
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": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790905271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12312 SAVANNA CT",
"city": "BISHOPVILLE",
"state": "MD",
"postal_code": "218131686",
"telephone_number": "410-352-3664",
"fax_number": "410-352-5654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10231 OLD OCEAN CITY BLVD",
"address_2": "STE 103, JAMES G. BARRETT MEDICAL BLDG",
"city": "BERLIN",
"state": "MD",
"postal_code": "21811",
"telephone_number": "410-629-0071",
"fax_number": "410-629-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISTOW-MARCALUS",
"first_name": "SUZANNE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "11206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.