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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH00758	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2056658	OTHER	PK

General Provider Information

NPI Number	:	1306861927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITHS FOOD & DRUG CENTERS INC

Provider Business Mailing Address
First Line	:	PO BOX 2918
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67504-2918
Country	:	US
Telephone Number	:	513-246-3894
Fax Number	:	513-762-1092

Provider Business Practice Location Address
First Line	:	4600 E SUNSET RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2202
Country	:	US
Telephone Number	:	702-451-0468
Fax Number	:	702-451-5939

Authorized Official
Title or Position	:	MANAGER OF PHARMACY LICENSING
Name	:	LYSETTE SEILHAMER
Credential	:
Telephone Number	:	513-762-1019

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	01/20/2023

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

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