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General NPI Number Information
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NPI Number | 1235675182
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Entity Type | Organization
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Legal Business Name | SMITH MANAGEMENT SERVICES LLC
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 99 MAPLE ST
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1595
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Country | US
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Telephone | 802-388-3784
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Fax | 802-388-1720
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Provider Business Mailing Address
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Address Line | 99 MAPLE ST STE 19
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1595
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Country | US
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Telephone | 802-458-3100
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Fax | 802-388-0872
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN PURSCELL
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Credential |
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Telephone | 802-388-1575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 038.0127445
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License Number State | VT
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