Provider Demographics
NPI:1689993776
Name:RATHFON, SUSAN MARY (RPH,CPI)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MARY
Last Name:RATHFON
Suffix:
Gender:F
Credentials:RPH,CPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LONGFIELDS WAY
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4487
Mailing Address - Country:US
Mailing Address - Phone:610-873-4192
Mailing Address - Fax:
Practice Address - Street 1:3807 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2216
Practice Address - Country:US
Practice Address - Phone:610-269-0226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031028L1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist