Provider Demographics
NPI:1730285677
Name:RUEDIGER, SUSAN SCHWAB (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:SCHWAB
Last Name:RUEDIGER
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 1:8 FARRELL RD
Mailing Address - Street 2:
Mailing Address - City:SANDY LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:16145-3308
Mailing Address - Country:US
Mailing Address - Phone:724-376-7378
Mailing Address - Fax:
Practice Address - Street 1:3289 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SANDY LAKE
Practice Address - State:PA
Practice Address - Zip Code:16145-3739
Practice Address - Country:US
Practice Address - Phone:724-376-3805
Practice Address - Fax:724-376-7456
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033728L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP033728LOtherSTATE LICENSE