MEDICARE: MEDSMART PHARMACY 5 LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1710867338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSMART PHARMACY 5 LLC

Provider Business Mailing Address
First Line	:	217 W BROAD ST
Second Line	:
City	:	SAINT PAULS
State	:	NC
Zip	:	28384-1533
Country	:	US
Telephone Number	:	910-865-4135
Fax Number	:

Provider Business Practice Location Address
First Line	:	7445 CLINTON RD
Second Line	:
City	:	STEDMAN
State	:	NC
Zip	:	28391-8901
Country	:	US
Telephone Number	:	910-323-4555
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH WILLIAMS
Credential	:	PHARMD
Telephone Number	:	910-865-4135

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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