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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 PharmacyPH00770NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12056670OTHERPK
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 : 1215952833
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 : 4440 N RANCHO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3406
Country : US
Telephone Number : 702-645-6200
Fax Number : 702-645-7399
Authorized Official
Title or Position : MANAGER OF PHARMACY CREDENTIALING
Name : KARLA LANGWORTHY
Credential :
Telephone Number : 513-698-1878
Provider Enumeration Date : 07/13/2006
Last Update Date : 08/18/2014

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

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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