MEDICARE: SAMANTHA Y SUH RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	41468	TX

General Provider Information

NPI Number	:	1689164840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA Y SUH RPH

Provider Business Mailing Address
First Line	:	3044 OLD DENTON RD STE 305
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5017
Country	:	US
Telephone Number	:	972-810-0078
Fax Number	:	972-810-0097

Provider Business Practice Location Address
First Line	:	3044 OLD DENTON RD STE 305
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5017
Country	:	US
Telephone Number	:	972-810-0078
Fax Number	:	972-810-0097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	09/29/2020

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Directions to “ SAMANTHA Y SUH RPH” Practice Location

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