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General NPI Number Information
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NPI Number | 1083907356
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Entity Type | Individual
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Provider Name | GERALD LEE SMITH JR. RPH
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Gender | Male
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 410 FAIRFAX PIKE
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City | STEPHENS CITY
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State | VA
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Zip | 22655-2969
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Country | US
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Telephone | 540-869-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 633 TREYS DR
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City | WINCHESTER
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State | VA
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Zip | 22601-3231
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Country | US
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Telephone | 540-678-1060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202007837
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License Number State | VA
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