Provider Demographics
NPI:1316714645
Name:R FLIPPIN SC
Entity type:Organization
Organization Name:R FLIPPIN SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLIPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:414-444-9242
Mailing Address - Street 1:4500 SUNNY ISLE STE 41
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4423
Mailing Address - Country:US
Mailing Address - Phone:414-793-3211
Mailing Address - Fax:
Practice Address - Street 1:4500 SUNNY ISLE STE 41
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4423
Practice Address - Country:US
Practice Address - Phone:414-793-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:R FLIPPIN SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy