Healthcare Provider Details

I. General information

NPI: 1730121302
Provider Name (Legal Business Name): SMITHS FOOD & DRUG CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 W RAY RD
CHANDLER AZ
85226-2064
US

IV. Provider business mailing address

500 S 99TH AVE
TOLLESON AZ
85353-9700
US

V. Phone/Fax

Practice location:
  • Phone: 480-940-7797
  • Fax: 480-705-5193
Mailing address:
  • Phone: 623-907-4933
  • Fax: 623-907-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberY003081
License Number StateAZ

VIII. Authorized Official

Name: KARLA LANGWORTHY
Title or Position: MANAGER OF PHARMACY CREDENTIALING
Credential:
Phone: 513-698-1878