Provider Demographics
NPI:1245643022
Name:GUPTON, SUSAN ADAIR (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ADAIR
Last Name:GUPTON
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:G120 MORGANTON HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5210
Mailing Address - Country:US
Mailing Address - Phone:828-433-8088
Mailing Address - Fax:828-438-0362
Practice Address - Street 1:G120 MORGANTON HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-5210
Practice Address - Country:US
Practice Address - Phone:828-433-8088
Practice Address - Fax:828-438-0362
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist