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General NPI Number Information
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NPI Number | 1033556816
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Entity Type | Individual
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Provider Name | SUSAN C PRESTON RPH
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Gender | Female
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 250 PETERSON AVE S
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City | DOUGLAS
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State | GA
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Zip | 31533-5237
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Country | US
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Telephone | 912-384-1898
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Fax | 912-383-7109
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Provider Business Mailing Address
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Address Line | PO BOX 2557
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City | DOUGLAS
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State | GA
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Zip | 31534-2557
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Country | US
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Telephone | 912-384-1898
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Fax | 912-383-7109
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH017755
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License Number State | GA
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