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NPI Code Detail

MEDICARE: NICHOLE SMITH PHARM.D

MEDICARE: NICHOLE SMITH PHARM.D
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
1183500000XPharmacistRP445436PA
2183500000XPharmacistPHA-18035CO

General Provider Information

NPI Number : 1164705521
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE SMITH PHARM.D
Provider Business Mailing Address
First Line : 550 W COLLEGE AVE
Second Line :
City : PLEASANT GAP
State : PA
Zip : 16823-7401
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 W COLLEGE AVE
Second Line :
City : PLEASANT GAP
State : PA
Zip : 16823-7401
Country : US
Telephone Number : 814-359-5641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 01/17/2013

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