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General NPI Number Information
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NPI Number | 1720332950
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Entity Type | Individual
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Provider Name | SUZANNE M KOESY RPH
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Gender | Female
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 9200 N RODNEY PARHAM RD WALGREENS PHARMACIST
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City | LITTLE ROCK
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State | AR
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Zip | 72227-6202
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Country | US
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Telephone | 501-223-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 4 BANGOR CT
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City | LITTLE ROCK
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State | AR
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Zip | 72223-4900
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Country | US
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Telephone | 501-765-3662
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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 | 07130
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License Number State | AR
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