MEDICARE: DEBORAH SUSAN SMITH

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	007648	KY
2	183500000X	Pharmacist	16140	FL

General Provider Information

NPI Number	:	1831489822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH SUSAN SMITH

Provider Business Mailing Address
First Line	:	3349 TATES CREEK RD
Second Line	:	LANSDOWNE SHOPPING CENTER
City	:	LEXINGTON
State	:	KY
Zip	:	40502-3467
Country	:	US
Telephone Number	:	859-266-0413
Fax Number	:	859-266-6463

Provider Business Practice Location Address
First Line	:	3349 TATES CREEK RD
Second Line	:	LANSDOWNE SHOPPING CENTER
City	:	LEXINGTON
State	:	KY
Zip	:	40502-3467
Country	:	US
Telephone Number	:	859-266-0413
Fax Number	:	859-266-6463

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

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	04/12/2011

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Directions to “ DEBORAH SUSAN SMITH ” Practice Location

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