Provider Demographics
NPI:1154547024
Name:WILLIAMS, SUZANNE TRUNK (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:TRUNK
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:MARIE
Other - Last Name:TRUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1106 MELLIEN DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-4053
Mailing Address - Country:US
Mailing Address - Phone:610-518-4859
Mailing Address - Fax:610-269-1176
Practice Address - Street 1:1106 MELLIEN DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-4053
Practice Address - Country:US
Practice Address - Phone:610-518-4859
Practice Address - Fax:610-269-1176
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist