Healthcare Provider Details

I. General information

NPI: 1609712793
Provider Name (Legal Business Name): CALESIA LASHA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10617 HIGHWAY 119
ALABASTER AL
35007-8738
US

IV. Provider business mailing address

133 CRESTMONT LN
PELHAM AL
35124-1806
US

V. Phone/Fax

Practice location:
  • Phone: 601-622-3058
  • Fax:
Mailing address:
  • Phone: 601-622-3058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: