MEDICARE: SMITH DRUG AND COMPOUNDING 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
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	AR20732	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2142796	OTHER		PK

General Provider Information

NPI Number	:	1184053571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH DRUG AND COMPOUNDING INC

Provider Business Mailing Address
First Line	:	1629 AIRPORT RD STE D
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8069
Country	:	US
Telephone Number	:	501-767-2220
Fax Number	:	501-463-4261

Provider Business Practice Location Address
First Line	:	1629 AIRPORT RD STE D
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-8069
Country	:	US
Telephone Number	:	501-767-2220
Fax Number	:	501-463-4261

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LANCE SMITH
Credential	:
Telephone Number	:	501-767-2220

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	12/16/2022

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Directions to “SMITH DRUG AND COMPOUNDING INC ” Practice Location

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