Healthcare Provider Details

I. General information

NPI: 1689646580
Provider Name (Legal Business Name): NORM SMITH PHARMD PHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BOX 26672
ALBUQUERQUE NM
87125-6672
US

IV. Provider business mailing address

PO BOX 26672
ALBUQUERQUE NM
87125-6672
US

V. Phone/Fax

Practice location:
  • Phone: 505-259-6548
  • Fax:
Mailing address:
  • Phone: 505-259-6548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number4456
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: