Provider Demographics
NPI:1902406606
Name:KIRBY, SUSAN CAROLINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:CAROLINE
Last Name:KIRBY
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 1:5225 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084-3657
Mailing Address - Country:US
Mailing Address - Phone:540-674-5745
Mailing Address - Fax:540-674-5769
Practice Address - Street 1:5225 ALEXANDER RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084-3657
Practice Address - Country:US
Practice Address - Phone:540-674-5745
Practice Address - Fax:540-674-5769
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist