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NPI Code Detail

MEDICARE: LEWIS GREGORY SMITH RPH, PHARMD

MEDICARE: LEWIS GREGORY SMITH RPH, 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
1183500000XPharmacist03443693OH

General Provider Information

NPI Number : 1649050030
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEWIS GREGORY SMITH RPH, PHARMD
Provider Business Mailing Address
First Line : 241 DRYDEN CT SW
Second Line :
City : CANTON
State : OH
Zip : 44706-1138
Country : US
Telephone Number : 234-521-2840
Fax Number :
Provider Business Practice Location Address
First Line : 4332 CLEVELAND AVE NW
Second Line :
City : CANTON
State : OH
Zip : 44709-2352
Country : US
Telephone Number : 330-649-9709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2023
Last Update Date : 10/03/2023

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