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General NPI Number Information
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NPI Number | 1114067956
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Entity Type | Organization
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Legal Business Name | SMITH DRUG CO
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 114 N TENNESSEE
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 972-542-4431
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Fax | 972-542-4303
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Provider Business Mailing Address
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Address Line | 114 N TENNESSEE
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 972-542-4431
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Fax | 972-542-4303
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Authorized Official
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Title or Position | PIC
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Name | MR. JIM M ELLIOTT SR.
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Credential | PHARMACIST
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Telephone | 972-542-4431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 22038
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License Number State | TX
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