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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 PharmacyY001788AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21988762OTHERPK

General Provider Information

NPI Number : 1336164953
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 : 1775 LAKESIDE DR
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-5732
Country : US
Telephone Number : 928-763-8777
Fax Number : 928-763-1869
Authorized Official
Title or Position : MANAGER OF PHARMACY LICENSING
Name : ALLISON MUENNICH
Credential :
Telephone Number : 513-762-1019
Provider Enumeration Date : 07/13/2006
Last Update Date : 09/19/2025

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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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