Healthcare Provider Details

I. General information

NPI: 1437170487
Provider Name (Legal Business Name): LARRYS SMITHFIELD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 09/15/2023
Certification Date: 09/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 S MAIN ST STE B
SMITHFIELD UT
84335-2314
US

IV. Provider business mailing address

502 S MAIN ST STE B
SMITHFIELD UT
84335-2314
US

V. Phone/Fax

Practice location:
  • Phone: 435-563-6262
  • Fax: 435-563-5277
Mailing address:
  • Phone: 435-563-6262
  • Fax: 435-563-5277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2774337-1703
License Number StateUT

VIII. Authorized Official

Name: LARRY DURRANT
Title or Position: OWNER PHARMACIST
Credential:
Phone: 435-563-6262