Provider Demographics
NPI:1255866083
Name:SMITH, PAULA (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E WEST HWY
Mailing Address - Street 2:APT 1611
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6247
Mailing Address - Country:US
Mailing Address - Phone:304-840-4862
Mailing Address - Fax:
Practice Address - Street 1:909 THAYER AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4507
Practice Address - Country:US
Practice Address - Phone:301-565-0689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-30
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist