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General NPI Number Information
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NPI Number | 1285529230
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Entity Type | Individual
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Provider Name | SUZANNE ANNIE SANDRA MPACKO PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 10125 WARD RD
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City | DUNKIRK
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State | MD
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Zip | 20754-2717
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Country | US
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Telephone | 443-550-1612
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Fax |
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Provider Business Mailing Address
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Address Line | 815 THAYER AVE APT 632
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City | SILVER SPRING
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State | MD
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Zip | 20910-4589
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Country | US
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Telephone | 240-381-0589
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Fax |
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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 | 30335
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License Number State | MD
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