Provider Demographics
NPI:1508885468
Name:JOHNSON, SUSAN C (PHARM D RPP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARM D RPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:859 CARRS POND ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-885-3414
Mailing Address - Fax:
Practice Address - Street 1:330 WASHINGTON ST SUITE 230
Practice Address - Street 2:EASTERN CT HEMATOLOGY & ONCOLOGY ANTICOAGULATION CLINIC
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360
Practice Address - Country:US
Practice Address - Phone:860-886-8856
Practice Address - Fax:860-886-9262
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7670183500000X
RI2761183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist