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General NPI Number Information
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NPI Number | 1851724637
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Entity Type | Organization
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Legal Business Name | NICHOLAS L SMITH PHARMACY LLC
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1914 FREEDOM RD
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City | LITTLE CHUTE
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State | WI
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Zip | 54140-1294
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Country | US
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Telephone | 920-788-8888
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Fax | 920-788-8883
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Provider Business Mailing Address
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Address Line | 1914 FREEDOM RD
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City | LITTLE CHUTE
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State | WI
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Zip | 54140-1294
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Country | US
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Telephone | 920-788-8888
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Fax | 920-788-8883
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Authorized Official
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Title or Position | OWNER / PHARMACIST
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Name | NICHOLAS LEE SMITH
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Credential | PHARMD
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Telephone | 920-788-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 9226-42
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 9226-42
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9226-42
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License Number State | WI
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