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General NPI Number Information
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NPI Number | 1386914950
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Entity Type | Individual
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Provider Name | BART ANDREW SMITH PHARM D
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Gender | Male
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 2431 W MAIN ST
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City | CARBONDALE
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State | IL
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Zip | 62901-1039
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Country | US
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Telephone | 618-457-0491
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 EMILY LN
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City | MARION
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State | IL
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Zip | 62959-5992
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Country | US
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Telephone | 618-917-5830
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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 | 051294216
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License Number State | IL
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