MEDICARE: SMITH DRUG COMPANY 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	3336C0002X	Clinic Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336C0003X	Community/Retail Pharmacy	AR20629	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0423397	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1831413566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH DRUG COMPANY INC

Provider Business Mailing Address
First Line	:	146 PASSION PLAY RD
Second Line	:	SUITE B
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-9495
Country	:	US
Telephone Number	:	479-253-6000
Fax Number	:	479-253-2226

Provider Business Practice Location Address
First Line	:	146 PASSION PLAY RD STE B
Second Line	:
City	:	EUREKA SPRINGS
State	:	AR
Zip	:	72632-9455
Country	:	US
Telephone Number	:	479-253-6000
Fax Number	:	479-253-2226

Authorized Official
Title or Position	:	PROPRIETOR/PHARMACIST
Name	:	DANNY SMITH
Credential	:
Telephone Number	:	479-253-6000

Provider Enumeration Date	:	03/24/2010
Last Update Date	:	01/22/2013

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Directions to “SMITH DRUG COMPANY INC ” Practice Location

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