MEDICARE: ROBERT KEVIN SMITH PHARM D, CGP, FASCP

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	1835G0303X	Geriatric Pharmacist	13594	NC

General Provider Information

NPI Number	:	1306999313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KEVIN SMITH PHARM D, CGP, FASCP

Provider Business Mailing Address
First Line	:	1096 WALNUT ACRES DR
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-7105
Country	:	US
Telephone Number	:	828-994-2140
Fax Number	:	828-994-2101

Provider Business Practice Location Address
First Line	:	947 N MAIN ST
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28115-2355
Country	:	US
Telephone Number	:	705-664-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2007
Last Update Date	:	07/08/2007

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