MEDICARE: SMITH'S 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
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1710715206
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH'S FOOD & DRUG CENTERS INC

Provider Business Mailing Address
First Line	:	1014 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-1141
Country	:	US
Telephone Number	:	513-762-1090
Fax Number	:	513-762-1092

Provider Business Practice Location Address
First Line	:	11701 W LONE MOUNTAIN PKWY
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85383-8164
Country	:	US
Telephone Number	:	480-372-2045
Fax Number	:	480-547-8920

Authorized Official
Title or Position	:	MANAGER PHARMACY LICENSING
Name	:	LYSETTE SEILHAMER
Credential	:
Telephone Number	:	513-587-5328

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	01/06/2026

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Directions to “SMITH'S FOOD & DRUG CENTERS INC ” Practice Location

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