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General NPI Number Information
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NPI Number | 1336742667
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Entity Type | Individual
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Provider Name | SHELDON CARROLL SMITH RPH
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Gender | Male
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 1036 E FORSYTH ST
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City | AMERICUS
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State | GA
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Zip | 31709-3722
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Country | US
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Telephone | 229-924-6917
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Fax | 229-924-2912
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Provider Business Mailing Address
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Address Line | 567 LAUREL RIDGE LN
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City | CATAULA
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State | GA
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Zip | 31804-2866
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Country | US
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Telephone | 706-653-6161
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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 | RPH017304
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License Number State | GA
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