Healthcare Provider Details

I. General information

NPI: 1437060100
Provider Name (Legal Business Name): SUSAN A DOLAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR
LEBANON NH
03756-1000
US

IV. Provider business mailing address

13 ESTABROOK CIR
WEST LEBANON NH
03784-1201
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0206X
TaxonomyCardiology Pharmacist
License NumberPHCY-01559
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: