Provider Demographics
NPI:1174296388
Name:SMITH, COLE DAVID (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:DAVID
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:COLE
Other - Middle Name:DAVID
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:1736 NEWARK RD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2630
Mailing Address - Country:US
Mailing Address - Phone:740-630-8492
Mailing Address - Fax:
Practice Address - Street 1:825 MAIN ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-3733
Practice Address - Country:US
Practice Address - Phone:740-452-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03440921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03440921OtherOHIO STATE BOARD OF PHARMACY LICENSE NUMBER