Provider Demographics
NPI:1164991816
Name:SMEDLEY, JACINTA ANN
Entity Type:Individual
Prefix:DR
First Name:JACINTA
Middle Name:ANN
Last Name:SMEDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 42ND ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-1572
Mailing Address - Country:US
Mailing Address - Phone:570-878-0355
Mailing Address - Fax:
Practice Address - Street 1:1070 N 9TH ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1210
Practice Address - Country:US
Practice Address - Phone:570-421-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist