MEDICARE: COURTNEY SMITH PHARMD

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	183500000X	Pharmacist	RPH034588	GA

General Provider Information

NPI Number	:	1205617016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY SMITH PHARMD

Provider Business Mailing Address
First Line	:	4801 EAGLES RIDGE LOOP
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30038-3533
Country	:	US
Telephone Number	:	770-715-2970
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 CRUSE RD
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-2658
Country	:	US
Telephone Number	:	770-715-2970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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Directions to “ COURTNEY SMITH PHARMD” Practice Location

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