Provider Demographics
NPI:1275629156
Name:LINDEMANN, SUSAN ELIZABETH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:LINDEMANN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:174 LINDEMANN LN
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2450
Mailing Address - Country:US
Mailing Address - Phone:636-629-0710
Mailing Address - Fax:636-629-4408
Practice Address - Street 1:855 N COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MO
Practice Address - Zip Code:63077-1118
Practice Address - Country:US
Practice Address - Phone:636-629-0710
Practice Address - Fax:636-629-4408
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist