Healthcare Provider Details

I. General information

NPI: 1679485817
Provider Name (Legal Business Name): ZUMAR AWARI SMITH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CVS DR
WOONSOCKET RI
02895-6146
US

IV. Provider business mailing address

569 SMITHFIELD RD APT 26
NORTH PROVIDENCE RI
02904-3880
US

V. Phone/Fax

Practice location:
  • Phone: 804-433-5802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074510
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: