Provider Demographics
NPI:1306109640
Name:HOWARD, SUSAN F (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:F
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6218 ESTELLE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-2173
Mailing Address - Country:US
Mailing Address - Phone:209-404-6218
Mailing Address - Fax:
Practice Address - Street 1:6218 ESTELLE AVE
Practice Address - Street 2:
Practice Address - City:RIVERBANK
Practice Address - State:CA
Practice Address - Zip Code:95367-2173
Practice Address - Country:US
Practice Address - Phone:209-404-6218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 41245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist