MEDICARE: ANDREW J SMITH PHARM.D.

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	1835P1200X	Pharmacotherapy Pharmacist	2000172536	MO

General Provider Information

NPI Number	:	1679729099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW J SMITH PHARM.D.

Provider Business Mailing Address
First Line	:	2464 CHARLOTTE ST
Second Line	:	HSB 4242
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2718
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2464 CHARLOTTE ST
Second Line	:	HSB 4242
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-2718
Country	:	US
Telephone Number	:	816-235-1791
Fax Number	:

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

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/18/2008

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