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General NPI Number Information
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NPI Number | 1790776912
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Entity Type | Organization
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Legal Business Name | JJJ SMITH, INC
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2425 DAVE WARD DR STE. 602
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City | CONWAY
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State | AR
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Zip | 72034-8686
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Country | US
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Telephone | 501-329-3777
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Fax | 501-329-7580
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Provider Business Mailing Address
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Address Line | 2425 DAVE WARD DR STE. 602
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City | CONWAY
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State | AR
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Zip | 72034-8686
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Country | US
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Telephone | 501-329-3777
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Fax | 501-329-7580
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | DAVID WILLIAM SMITH
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Credential | P.D.
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Telephone | 501-327-3777
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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 | AR-13194
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License Number State | AR
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