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General NPI Number Information
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NPI Number | 1528140308
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Entity Type | Organization
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Legal Business Name | SMA GROUP INCORPORATED
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 8067 W VIRGINIA DR
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City | DALLAS
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State | TX
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Zip | 75237-3767
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Country | US
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Telephone | 214-635-3435
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Fax | 214-635-3440
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Provider Business Mailing Address
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Address Line | PO BOX 1893
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City | MANSFIELD
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State | TX
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Zip | 76063-0017
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Country | US
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Telephone | 214-635-3435
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Fax | 214-635-3440
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Authorized Official
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Title or Position | OFFICER
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Name | ANDREW KORN
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Credential |
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Telephone | 214-521-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 25286
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License Number State | TX
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