MEDICARE: DR. JERRY D SMITH PHARMD, BCPS

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	PS31876	FL
2	1835P1200X	Pharmacotherapy Pharmacist	PS31876	FL

General Provider Information

NPI Number	:	1437144250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY D SMITH PHARMD, BCPS

Provider Business Mailing Address
First Line	:	195 KEL WEN CIR
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-3712
Country	:	US
Telephone Number	:	850-650-3644
Fax Number	:

Provider Business Practice Location Address
First Line	:	7800 US HIGHWAY 98 W
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32550-7228
Country	:	US
Telephone Number	:	850-278-3579
Fax Number	:	850-278-3583

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

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	09/11/2025

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