Provider Demographics
NPI:1952570632
Name:BLESSING, SUSAN PAULA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:PAULA
Last Name:BLESSING
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 1:2322 SMITHS LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-2333
Mailing Address - Country:US
Mailing Address - Phone:302-475-7368
Mailing Address - Fax:
Practice Address - Street 1:3901 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1514
Practice Address - Country:US
Practice Address - Phone:302-995-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001863183500000X
PARP030936L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA1-0001863OtherPHARMACY
PARP030936LOtherPHARMACY