Healthcare Provider Details

I. General information

NPI: 1154979649
Provider Name (Legal Business Name): RORY SMITH PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 BIG HORN AVE
WORLAND WY
82401-2912
US

IV. Provider business mailing address

1801 BIG HORN AVE
WORLAND WY
82401-2912
US

V. Phone/Fax

Practice location:
  • Phone: 307-347-2281
  • Fax: 307-347-3736
Mailing address:
  • Phone: 307-347-2281
  • Fax: 307-347-3736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4177
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: