Healthcare Provider Details

I. General information

NPI: 1467849323
Provider Name (Legal Business Name): BEN SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2015
Last Update Date: 04/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9947 KINGSTON PIKE HEARTLAND APOTHECARY
KNOXVILLE TN
37922-6923
US

IV. Provider business mailing address

661 ROBERTSVILLE RD
OAK RIDGE TN
37830-4606
US

V. Phone/Fax

Practice location:
  • Phone: 865-909-9713
  • Fax:
Mailing address:
  • Phone: 865-202-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000033276
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: