Provider Demographics
NPI:1740323013
Name:JOHNSON, SUSAN HEDRICK (BS, PHARM D)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HEDRICK
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BS, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 BIBLE CAMP LN
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-8077
Mailing Address - Country:US
Mailing Address - Phone:828-635-1107
Mailing Address - Fax:828-315-5741
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:PHARMACY -AMS CLINIC
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5046
Practice Address - Country:US
Practice Address - Phone:828-315-3803
Practice Address - Fax:828-315-3212
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist