Provider Demographics
NPI:1720192941
Name:NOE, SUZANNE MARIE (RPH)
Entity Type:Individual
Prefix:MISS
First Name:SUZANNE
Middle Name:MARIE
Last Name:NOE
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 1:790 SANDALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-1644
Mailing Address - Country:US
Mailing Address - Phone:248-828-2229
Mailing Address - Fax:
Practice Address - Street 1:30055 NORTHWESTERN HWY STE 225
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3231
Practice Address - Country:US
Practice Address - Phone:248-865-3770
Practice Address - Fax:248-865-3771
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist