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General NPI Number Information
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NPI Number | 1134340466
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Entity Type | Individual
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Provider Name | JAN T. SMITH RPH
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 CRESCENT CENTER PKWY
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City | TUCKER
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State | GA
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Zip | 30084-7047
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Country | US
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Telephone | 770-496-3523
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Fax |
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Provider Business Mailing Address
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Address Line | 1757 NOTTINGHAM DR
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City | GAINESVILLE
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State | GA
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Zip | 30501-2030
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Country | US
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Telephone | 770-532-9094
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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 | 10100
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License Number State | GA
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