MEDICARE: CHAD SMITH

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	22721	OH

General Provider Information

NPI Number	:	1689278889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAD SMITH

Provider Business Mailing Address
First Line	:	407 N FRONT ST
Second Line	:
City	:	OAK HILL
State	:	OH
Zip	:	45656-1268
Country	:	US
Telephone Number	:	740-682-3525
Fax Number	:	740-682-6917

Provider Business Practice Location Address
First Line	:	407 N FRONT ST
Second Line	:
City	:	OAK HILL
State	:	OH
Zip	:	45656-1268
Country	:	US
Telephone Number	:	740-682-3525
Fax Number	:	740-682-6917

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

Provider Enumeration Date	:	11/28/2020
Last Update Date	:	11/28/2020

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Directions to “ CHAD SMITH ” Practice Location

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