Provider Demographics
NPI:1003255522
Name:SMART, KATHRYN (RPH, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:SMART
Suffix:
Gender:F
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 HEARTLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241
Mailing Address - Country:US
Mailing Address - Phone:319-545-4600
Mailing Address - Fax:319-545-4606
Practice Address - Street 1:2751 HEARTLAND DR
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2731
Practice Address - Country:US
Practice Address - Phone:319-545-4600
Practice Address - Fax:319-545-4606
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist