Provider Demographics
NPI:1689928285
Name:STRICKLAND, SUSAN CAROL (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:CAROL
Last Name:STRICKLAND
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 1:526 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3849
Mailing Address - Country:US
Mailing Address - Phone:706-861-2771
Mailing Address - Fax:706-866-5195
Practice Address - Street 1:526 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3849
Practice Address - Country:US
Practice Address - Phone:706-861-2771
Practice Address - Fax:706-866-5195
Is Sole Proprietor?:No
Enumeration Date:2012-11-04
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017385183500000X
TN0000009281183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist