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NPI Code Detail

MEDICARE: SUSAN KATHLEEN WERNER HUCK R.PH.

MEDICARE: SUSAN KATHLEEN WERNER HUCK R.PH.
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
1183500000XPharmacist03314376OH

General Provider Information

NPI Number : 1528359155
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN KATHLEEN WERNER HUCK R.PH.
Provider Business Mailing Address
First Line : 2900 MEADOW PARK DR
Second Line :
City : KETTERING
State : OH
Zip : 45440-1421
Country : US
Telephone Number : 937-296-1435
Fax Number : 937-296-1435
Provider Business Practice Location Address
First Line : 1158 WILMINGTON AVE
Second Line :
City : DAYTON
State : OH
Zip : 45420-1662
Country : US
Telephone Number : 937-252-9894
Fax Number : 937-256-8062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2011
Last Update Date : 04/30/2011

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