Healthcare Provider Details

I. General information

NPI: 1992882484
Provider Name (Legal Business Name): STEVEN ROBERT SMITH RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 HUGHES DR
TOLEDO OH
43606-3856
US

IV. Provider business mailing address

523 CAMBRIDGE PARK S
MAUMEE OH
43537-2349
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2114
  • Fax:
Mailing address:
  • Phone: 419-367-7394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03-2-13282
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: