Provider Demographics
NPI:1811174436
Name:HILL, SUSAN ELIZABETH (RPH)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:HILL
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 1:700 W CLAY RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:MO
Mailing Address - Zip Code:65084-1012
Mailing Address - Country:US
Mailing Address - Phone:573-378-5000
Mailing Address - Fax:573-378-9610
Practice Address - Street 1:VERSAILLES PHARMACY
Practice Address - Street 2:700 WEST CLAY ROAD
Practice Address - City:VERSAILLES
Practice Address - State:MO
Practice Address - Zip Code:65084
Practice Address - Country:US
Practice Address - Phone:573-378-5000
Practice Address - Fax:573-378-1920
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000152180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist