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Organization

SUSONG-SYDNOR INC

Active
Other names
HOWARDS PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES SUSONG PHARMD (PRESIDENT)
(423) 639-8631
Entity
Organization

Contact information

Practice address
1305 TUSCULUM BLVD # B, STE 2, GREENEVILLE, TN 37745-4160
(423) 639-5134
(423) 639-5134
Mailing address
1305 TUSCULUM BLVD # B, STE 2, GREENEVILLE, TN 37745-4160
(423) 639-5134
(423) 639-5134

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
2195
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4426121
NCPDP PROVIDER IDENTIFICATION NUMBER
05
9449650
TN
Enumeration date
10/26/2006
Last updated
02/15/2012
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