MEDICARE: DR. DOUGLAS LAMONT SMITH PHARM.D.

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	1835N1003X	Nutrition Support Pharmacist	0202006094	VA
2	1835X0200X	Oncology Pharmacist	0202006094	VA

General Provider Information

NPI Number	:	1356645113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS LAMONT SMITH PHARM.D.

Provider Business Mailing Address
First Line	:	1751 WARDENSVILLE PIKE
Second Line	:
City	:	STAR TANNERY
State	:	VA
Zip	:	22654-1831
Country	:	US
Telephone Number	:	540-465-9029
Fax Number	:	540-542-6298

Provider Business Practice Location Address
First Line	:	1775 N SECTOR CT
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2859
Country	:	US
Telephone Number	:	540-678-4396
Fax Number	:	540-542-6298

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

Provider Enumeration Date	:	01/07/2011
Last Update Date	:	01/07/2011

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