Healthcare Provider Details
I. General information
NPI: 1629392667
Provider Name (Legal Business Name): SMITHS FOOD & DRUG CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/19/2010
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16380 W YUMA RD
GOODYEAR AZ
85338-3100
US
IV. Provider business mailing address
P.O. BOX 842772
BOSTON MA
02284
US
V. Phone/Fax
- Phone: 623-925-4442
- Fax: 623-925-4443
- Phone: 513-762-1019
- Fax: 513-762-1092
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | Y005254 |
| License Number State | AZ |
VIII. Authorized Official
Name:
ALLISON
MUENNICH
Title or Position: MANAGER OF PHARMACY LICENSING
Credential:
Phone: 513-762-1019