Provider Demographics
NPI:1508423864
Name:RHODUS, SUSAN MARY (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:RHODUS
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 1:3311 BROECK POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2550
Mailing Address - Country:US
Mailing Address - Phone:502-541-4579
Mailing Address - Fax:
Practice Address - Street 1:3311 BROECK POINTE CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2550
Practice Address - Country:US
Practice Address - Phone:502-541-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0101271835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric