Healthcare Provider Details

I. General information

NPI: 1578477857
Provider Name (Legal Business Name): EMMA SYDNEY SMITH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 E BROADWAY ST
MOUNT PLEASANT MI
48858-2312
US

IV. Provider business mailing address

121 E BROADWAY ST
MOUNT PLEASANT MI
48858-2312
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-5544
  • Fax:
Mailing address:
  • Phone: 989-773-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302418958
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: