MEDICARE: MR. JEFFREY R 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	A1-0002598	DE

General Provider Information

NPI Number	:	1710944319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY R SMITH RPH

Provider Business Mailing Address
First Line	:	1658 ROYAL BERKSHIRE CIR
Second Line	:
City	:	WEST CHESTER
State	:	PA
Zip	:	19380-1598
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 DARLEY RD
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-2723
Country	:	US
Telephone Number	:	302-798-6641
Fax Number	:	302-798-1824

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	07/08/2007

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