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General NPI Number Information
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NPI Number | 1962556225
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Entity Type | Organization
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Legal Business Name | SMITH & STEWART DRUG
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 102 SAGE ST N
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City | TOCCOA
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State | GA
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Zip | 30577-2336
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Country | US
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Telephone | 706-886-3141
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Fax | 706-886-4000
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Provider Business Mailing Address
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Address Line | 102 N SAGE ST
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City | TOCCOA
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State | GA
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Zip | 30577-3678
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Country | US
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Telephone | 706-886-3141
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Fax | 706-886-4000
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Authorized Official
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Title or Position | OWNER AND PRESIDENT OF CORPORATION
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Name | DR. JEFF A DALTON
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Credential | RPH, PHARM D
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Telephone | 706-886-3141
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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 | PHRE006339
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License Number State | GA
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