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General NPI Number Information
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NPI Number | 1598779969
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Entity Type | Individual
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Provider Name | JOSEPH NICHOLAS SMOLEY R.PH.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/03/2008
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Provider Practice Location Address
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Address Line | 1406 6TH AVE N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1900
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Country | US
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Telephone | 320-251-2700
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Fax | 320-656-7048
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Provider Business Mailing Address
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Address Line | 1100 24TH AVE NE
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City | SAUK RAPIDS
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State | MN
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Zip | 56379-4600
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Country | US
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Telephone | 320-251-9267
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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 | 112253-4
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License Number State | MN
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