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General NPI Number Information
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NPI Number | 1861614679
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Entity Type | Individual
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Provider Name | RICKEY L. SMITH RPH
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1008 NEVADA HIGHWAY
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City | BOULDER CITY
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State | NV
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Zip | 89005
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Country | US
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Telephone | 702-293-7592
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 ELATION LANE UNIT 103
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City | HENDERSON
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State | NV
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Zip | 89002
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Country | US
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Telephone | 805-750-2232
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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 | 16694
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License Number State | NV
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