MEDICARE: ANDREW PRESTON 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	051173	NY

General Provider Information

NPI Number	:	1932778511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW PRESTON SMITH

Provider Business Mailing Address
First Line	:	255 DANBURY CIR S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 BELLWOOD DR
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-4226
Country	:	US
Telephone Number	:	585-305-3479
Fax Number	:

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

Provider Enumeration Date	:	06/18/2021
Last Update Date	:	06/18/2021

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