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NPI Code Detail

MEDICARE: DR. SHATARRA F SMITH PHARMD

MEDICARE: DR. SHATARRA F SMITH PHARMD
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
1183500000XPharmacist18750NC

General Provider Information

NPI Number : 1164745485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHATARRA F SMITH PHARMD
Provider Business Mailing Address
First Line : 4701 SOUTH BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-2117
Country : US
Telephone Number : 704-523-3227
Fax Number : 704-523-8468
Provider Business Practice Location Address
First Line : 4701 SOUTH BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-2117
Country : US
Telephone Number : 704-523-3227
Fax Number : 704-523-8468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2010
Last Update Date : 03/02/2010

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