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NPI Code Detail

MEDICARE: SMITHS FOOD & DRUG CENTERS INC

MEDICARE: SMITHS FOOD & DRUG CENTERS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
2332B00000XDurable Medical Equipment & Medical Supplies
33336C0003XCommunity/Retail PharmacyPH01770NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12051653OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154348779
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMITHS FOOD & DRUG CENTERS INC
Provider Business Mailing Address
First Line : PO BOX 30550
Second Line : MS 44010 010C
City : SALT LAKE CITY
State : UT
Zip : 84130-0550
Country : US
Telephone Number : 801-974-1402
Fax Number : 801-973-1704
Provider Business Practice Location Address
First Line : 6150 W FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2280
Country : US
Telephone Number : 702-876-8753
Fax Number : 702-873-7159
Authorized Official
Title or Position : PHARMACY LICENSING MANAGER
Name : ZACH STONE
Credential :
Telephone Number : 513-762-1019
Provider Enumeration Date : 07/17/2006
Last Update Date : 12/03/2013

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Directions to “SMITHS FOOD & DRUG CENTERS INC ” Practice Location

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