Provider Demographics
NPI:1154636512
Name:SCHWAGER, SUSAN LAURA (RPH)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LAURA
Last Name:SCHWAGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 SWEETWATER RD
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-9555
Mailing Address - Country:US
Mailing Address - Phone:828-808-0555
Mailing Address - Fax:
Practice Address - Street 1:10 NEW CLYDE HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4210
Practice Address - Country:US
Practice Address - Phone:828-648-4468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist