MEDICARE: ANNETTE ELAINE SMITH RPH

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	183500000X	Pharmacist	009629	KY

General Provider Information

NPI Number	:	1487038600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE ELAINE SMITH RPH

Provider Business Mailing Address
First Line	:	518 BETHEL PL
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1706
Country	:	US
Telephone Number	:	270-338-5838
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 S MAIN ST
Second Line	:
City	:	GREENVILLE
State	:	KY
Zip	:	42345-1507
Country	:	US
Telephone Number	:	270-338-4241
Fax Number	:

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

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	07/17/2015

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Directions to “ ANNETTE ELAINE SMITH RPH” Practice Location

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