Susan Margaret Shields, RPH

Individual provider Active NPI Pharmacist · Mitchellville, IA

NPI 1891713426 · NPPES record last updated Apr 4, 2018

Key facts

NPI
1891713426
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
16321 (IA)
Practice address
250 Elm Avenue SW
Mitchellville, IA 50169
Phone
(515) 725-5065
Fax
(515) 725-5070
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

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

LicenseStateTypeSpecialty
16321IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Des Moines Central Correctional Pharmacy Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16321 IA Yes

Addresses

Primary practice location

250 Elm Avenue SW
Mitchellville, IA 50169

Mailing address

732 18TH St Apt 401
Des Moines, IA 50314-1027
Phone (515) 571-5957

Other identifiers

IdentifierTypeStateIssuer
1891713426OtherNPI

Other providers in Mitchellville, IA

All providers in Mitchellville, IA · Pharmacist in Iowa

Sources for this page

Verify at the official NPI Registry.