Susan K Green, RPH
Individual provider Active NPI Pharmacist · Gadsden, AL
NPI 1902128705 · NPPES record last updated Oct 15, 2015
Key facts
- NPI
- 1902128705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11936 (AL)
- Practice address
- 911 Rainbow Drive
Gadsden City Pharmacy
Gadsden, AL 35901-1513 - Phone
- (256) 547-4479
- Fax
- (256) 549-0577
- NPI assigned
- Feb 19, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11936 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gadsden Pharmacy LLC | Pharmacist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11936 | AL | Yes |
Addresses
Primary practice location
911 Rainbow Drive
Gadsden City Pharmacy
Gadsden, AL 35901-1513
Mailing address
911 Rainbow Dr
Gadsden City Pharmacy
Gadsden, AL 35901-5309
Phone (256) 547-4479
Other providers in Gadsden, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.