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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
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
33336C0003XCommunity/Retail PharmacyY002096AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21988999OTHERPK

General Provider Information

NPI Number : 1194767764
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMITHS FOOD & DRUG CENTERS INC
Provider Business Mailing Address
First Line : PO BOX 842772
Second Line :
City : BOSTON
State : MA
Zip : 02284-2772
Country : US
Telephone Number : 513-762-1019
Fax Number : 513-762-1092
Provider Business Practice Location Address
First Line : 744 W CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-2207
Country : US
Telephone Number : 602-279-9337
Fax Number : 602-279-0763
Authorized Official
Title or Position : MANAGER OF PHARMACY LICENSING
Name : ALLISON MUENNICH
Credential :
Telephone Number : 513-762-1019
Provider Enumeration Date : 06/11/2006
Last Update Date : 05/16/2016

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Practice Location Address:
744 W CAMELBACK RD
PHOENIX, AZ
85013-2207
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Practice Fax:
1700139193 — ELIZABETH RACHEL PAAU
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85013-2207
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Practice Location Address:
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85013-2207
Practice Phone: 602-279-9337
Practice Fax: 602-279-0763

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

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