Provider Demographics
NPI:1225248040
Name:SMITH, RONALD ROY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:ROY
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:AL
Mailing Address - Zip Code:35905-1060
Mailing Address - Country:US
Mailing Address - Phone:256-492-4900
Mailing Address - Fax:256-492-4944
Practice Address - Street 1:544 MAIN ST W
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:AL
Practice Address - Zip Code:35905-1060
Practice Address - Country:US
Practice Address - Phone:256-492-4900
Practice Address - Fax:256-492-4944
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6407183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist