MEDICARE: SMITH'S PHARMACY INC

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	333600000X	Pharmacy	PP481348	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3982938	OTHER		NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063410272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH'S PHARMACY INC

Provider Business Mailing Address
First Line	:	1331 E WYOMING AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-3000
Fax Number	:	215-537-9520

Provider Business Practice Location Address
First Line	:	1331 E WYOMING AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19124-3808
Country	:	US
Telephone Number	:	215-537-3000
Fax Number	:	215-537-9520

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID B SMITH
Credential	:
Telephone Number	:	215-537-3000

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	08/22/2020

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Directions to “SMITH'S PHARMACY INC ” Practice Location

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