Provider Demographics
NPI:1235215666
Name:SMITH, DAVID HAROLD
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HAROLD
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-2623
Mailing Address - Country:US
Mailing Address - Phone:308-345-5268
Mailing Address - Fax:
Practice Address - Street 1:JUNCTION OF HWY 83 AND HWY 6-34
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001
Practice Address - Country:US
Practice Address - Phone:308-345-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist