Healthcare Provider Details

I. General information

NPI: 1548341134
Provider Name (Legal Business Name): SONDI SMITH VEST RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S MARBLE ST
ROCKMART GA
30153-2642
US

IV. Provider business mailing address

208 SAMANDA CIR
ROCKMART GA
30153-2183
US

V. Phone/Fax

Practice location:
  • Phone: 770-684-6573
  • Fax: 770-684-4553
Mailing address:
  • Phone: 770-684-7385
  • Fax: 770-684-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number018953
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: