Active NPI
Susanne Inman Faircloth, RPH
- Pharmacist
- Pembroke, NC
National Provider Identifier
1841764503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17203
- Practice address
- 812 Candy Park Rd Ste 7101
Pembroke, NC 28372-9129 - Phone
- (910) 522-1041
- Fax
- (910) 522-1085
- NPI assigned
- Jan 16, 2019
- Last updated
- Jan 16, 2019
- 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 | 17203 | NC | Primary |
Addresses
Primary practice location
812 Candy Park Rd Ste 7101
Pembroke, NC 28372-9129
Mailing address
PO Box 2760
Pembroke, NC 28372-2760
Phone (910) 522-1041
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 |
|---|---|---|---|
| 17203 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RSB Faircloth Inc | Current | Accepting new patients |
Locations
812 Candy Park Rd
Ste 7101
Pembroke, NC 28372
Phone (910) 522-1041
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": "1547596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547596800000",
"number": "1841764503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2760",
"city": "PEMBROKE",
"state": "NC",
"postal_code": "283722760",
"telephone_number": "910-522-1041",
"fax_number": "910-522-1085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 CANDY PARK RD STE 7101",
"city": "PEMBROKE",
"state": "NC",
"postal_code": "283729129",
"telephone_number": "910-522-1041",
"fax_number": "910-522-1085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRCLOTH",
"first_name": "SUSANNE",
"middle_name": "INMAN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-16",
"last_updated": "2019-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "17203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.