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NPI Code Detail

MEDICARE: CLAYTON JAY SMITH R.PH.

MEDICARE: CLAYTON JAY SMITH R.PH.
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
1183500000XPharmacist06500NC

General Provider Information

NPI Number : 1730460676
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAYTON JAY SMITH R.PH.
Provider Business Mailing Address
First Line : 1615 SPRING GARDEN ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-2334
Country : US
Telephone Number : 336-379-1649
Fax Number : 336-691-1239
Provider Business Practice Location Address
First Line : 1615 SPRING GARDEN ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-2334
Country : US
Telephone Number : 336-379-1649
Fax Number : 336-691-1239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 09/06/2011

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