Provider Demographics
NPI:1356691463
Name:SCHMITT BECKMANN, SUSAN KAY (RPH)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:KAY
Last Name:SCHMITT BECKMANN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:KAY
Other - Last Name:SCHMITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:5867 MOONBEAM DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-6010
Mailing Address - Country:US
Mailing Address - Phone:703-583-5730
Mailing Address - Fax:
Practice Address - Street 1:5867 MOONBEAM DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-6010
Practice Address - Country:US
Practice Address - Phone:703-583-5730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205417183500000X
FLPS27377183500000X
MI5302023714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist