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General NPI Number Information
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NPI Number | 1396098802
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Entity Type | Individual
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Provider Name | PENELOPE JANE SMITH PHARM D.
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Gender | Female
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1250 E ALMOND AVE
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City | MADERA
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State | CA
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Zip | 93637-5606
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Country | US
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Telephone | 559-675-5545
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Fax |
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Provider Business Mailing Address
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Address Line | 6537 N GREGORY AVE
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City | FRESNO
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State | CA
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Zip | 93722-8800
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Country | US
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Telephone | 559-274-0679
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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 | 55587
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License Number State | CA
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