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General NPI Number Information
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NPI Number | 1720627458
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Entity Type | Individual
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Provider Name | SUSAN CURRY
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Gender | Female
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Dates
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Enumeration Date | 12/28/2019
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Last Update Date | 12/28/2019
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Provider Practice Location Address
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Address Line | 4526 W WESTERN AVE
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City | SOUTH BEND
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State | IN
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Zip | 46619-2302
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Country | US
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Telephone | 574-239-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 50914 PINE MEADOWS DR
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City | GRANGER
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State | IN
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Zip | 46530-8326
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Country | US
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Telephone | 574-360-8980
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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 | 26019058A
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License Number State | IN
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