Healthcare Provider Details
I. General information
NPI: 1396770236
Provider Name (Legal Business Name): SMITH'S DRUGS OF FOREST CITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
139 E MAIN ST
FOREST CITY NC
28043-3125
US
IV. Provider business mailing address
PO BOX 5047
MERIDIAN MS
39302-5047
US
V. Phone/Fax
- Phone: 828-245-9215
- Fax: 828-245-5013
- Phone: 800-447-4095
- Fax: 601-482-7490
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | 07506 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336M0002X |
| Taxonomy | Mail Order Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | 07506 |
| License Number State | NC |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 07506 |
| License Number State | NC |
VIII. Authorized Official
Name:
JOHN
H
HIGGINS
Title or Position: PRESIDENT
Credential:
Phone: 828-245-9215