Organization
SUSONG PHARMACY INC
Active
Organization
SUSONG PHARMACY INC
Active
Other names
SUSONG PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SUSONG PHRM D (PRESIDENT)
(423) 639-8631
Entity
Organization
Contact information
Practice address
2255 E ANDREW JOHNSON HWY, GREENEVILLE, TN 37745-4375
(423) 639-8631
(423) 639-0302
Mailing address
2255 E ANDREW JOHNSON HWY, SUITE 2, GREENEVILLE, TN 37745-4375
(423) 639-8631
(423) 639-0302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
177
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4415495
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
9448308
—
TN
Enumeration date
10/26/2006
Last updated
02/15/2012
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