Provider Demographics
NPI:1891382156
Name:SMITH, SUZANNE S (RPH)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:N/A
Other - Last Name:STOOPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1520 W CARO RD
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-9260
Mailing Address - Country:US
Mailing Address - Phone:989-673-7020
Mailing Address - Fax:866-317-9946
Practice Address - Street 1:1520 W CARO RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9260
Practice Address - Country:US
Practice Address - Phone:989-673-7020
Practice Address - Fax:866-317-9946
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017704A183500000X
MI5302029886183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist