Healthcare Provider Details

I. General information

NPI: 1003199027
Provider Name (Legal Business Name): KAREN SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 DIXIE HWY
FT WRIGHT KY
41011-2646
US

IV. Provider business mailing address

3632 TAMBER RIDGE DR
COVINGTON KY
41015-2492
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-0370
  • Fax:
Mailing address:
  • Phone: 513-807-7714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number014200
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03328882
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: