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NPI Code Detail

MEDICARE: MALLORY KAY SMITH PHARMD

MEDICARE: MALLORY KAY SMITH PHARMD
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
1183500000XPharmacist4739HI

General Provider Information

NPI Number : 1396484739
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY KAY SMITH PHARMD
Provider Business Mailing Address
First Line : 84-929 HANA ST # B
Second Line :
City : WAIANAE
State : HI
Zip : 96792-2251
Country : US
Telephone Number : 702-478-0222
Fax Number :
Provider Business Practice Location Address
First Line : 91-1401 FORT WEAVER RD
Second Line :
City : EWA BEACH
State : HI
Zip : 96706-2253
Country : US
Telephone Number : 808-685-5621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2022
Last Update Date : 06/02/2022

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Directions to “ MALLORY KAY SMITH PHARMD” Practice Location

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