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NPI Code Detail

MEDICARE: DR. SUSAN SHUTT RASBACH PHARM D.

MEDICARE: DR. SUSAN SHUTT RASBACH PHARM D.
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
1183500000XPharmacist29379TN

General Provider Information

NPI Number : 1356680110
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN SHUTT RASBACH PHARM D.
Provider Business Mailing Address
First Line : 395 WHITEHALL CT
Second Line :
City : EADS
State : TN
Zip : 38028-3301
Country : US
Telephone Number : 731-607-4634
Fax Number : 901-290-9271
Provider Business Practice Location Address
First Line : 11635 HIGHWAY 70
Second Line :
City : ARLINGTON
State : TN
Zip : 38002-9778
Country : US
Telephone Number : 901-290-9270
Fax Number : 901-290-9271
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2013
Last Update Date : 02/13/2013

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