Healthcare Provider Details

I. General information

NPI: 1073625778
Provider Name (Legal Business Name): MARGARET LEWIS SMITH R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 BROADWAY AVE
ASHFORD AL
36312
US

IV. Provider business mailing address

PO BOX 465
COTTONWOOD AL
36320-0465
US

V. Phone/Fax

Practice location:
  • Phone: 334-899-3100
  • Fax: 334-899-3186
Mailing address:
  • Phone: 334-691-4567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number9158
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22988
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20356
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: