MEDICARE: SUSAN KAPTUR RPH

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
1	183500000X	Pharmacist	26016060A	IN

General Provider Information

NPI Number	:	1376825844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN KAPTUR RPH

Provider Business Mailing Address
First Line	:	1835 ROSEWOOD LN
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-5148
Country	:	US
Telephone Number	:	219-934-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	407 W GLEN PARK AVE
Second Line	:
City	:	GRIFFITH
State	:	IN
Zip	:	46319-1511
Country	:	US
Telephone Number	:	219-924-2701
Fax Number	:	219-924-8691

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	09/12/2011

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Directions to “ SUSAN KAPTUR RPH” Practice Location

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