Provider Demographics
NPI:1164745485
Name:SMITH, SHATARRA F (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHATARRA
Middle Name:F
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-2117
Mailing Address - Country:US
Mailing Address - Phone:704-523-3227
Mailing Address - Fax:704-523-8468
Practice Address - Street 1:4701 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-2117
Practice Address - Country:US
Practice Address - Phone:704-523-3227
Practice Address - Fax:704-523-8468
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist