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NPI Code Detail

MEDICARE: MS. SUSAN PATRICIA WILLIAMS PHARMD

MEDICARE: MS. SUSAN PATRICIA WILLIAMS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist16918NV
2183500000XPharmacist58427CA
3183500000XPharmacistPH00061430WA

General Provider Information

NPI Number : 1215919683
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN PATRICIA WILLIAMS PHARMD
Provider Business Mailing Address
First Line : PO BOX 1618
Second Line :
City : GARDNERVILLE
State : NV
Zip : 89410-1618
Country : US
Telephone Number : 775-229-2290
Fax Number :
Provider Business Practice Location Address
First Line : 1600 MEDICAL PKWY
Second Line :
City : CARSON CITY
State : NV
Zip : 89703-4625
Country : US
Telephone Number : 775-445-8650
Fax Number : 775-445-8655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 05/02/2008

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