Provider Demographics
NPI:1023366978
Name:SMITH, DAVID REID (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:REID
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-1352
Mailing Address - Country:US
Mailing Address - Phone:864-445-7580
Mailing Address - Fax:864-445-2344
Practice Address - Street 1:321 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-1352
Practice Address - Country:US
Practice Address - Phone:864-445-7580
Practice Address - Fax:864-445-2344
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC004793183500000X
NC12953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist