Provider Demographics
NPI:1164451969
Name:BEX, SUSAN DENISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:DENISE
Last Name:BEX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 WEST 10TH STREET
Mailing Address - Street 2:PHARMACY SERVICES (119)
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202
Mailing Address - Country:US
Mailing Address - Phone:317-988-2144
Mailing Address - Fax:317-988-3334
Practice Address - Street 1:1481 WEST 10TH STREET
Practice Address - Street 2:PHARMACY SERVICES (119)
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-988-2144
Practice Address - Fax:317-988-3334
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020813A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy