Provider Demographics
NPI:1902043961
Name:CARY, SUSAN H (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:H
Last Name:CARY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 ANGEL CV
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-2014
Mailing Address - Country:US
Mailing Address - Phone:731-986-3803
Mailing Address - Fax:731-986-2171
Practice Address - Street 1:630 RB WILSON DR
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1726
Practice Address - Country:US
Practice Address - Phone:731-986-2228
Practice Address - Fax:731-986-2171
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist