Provider Demographics
NPI:1275128415
Name:SMITH, ALLEN M (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-8603
Mailing Address - Country:US
Mailing Address - Phone:423-839-1663
Mailing Address - Fax:
Practice Address - Street 1:6161 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:TALBOTT
Practice Address - State:TN
Practice Address - Zip Code:37877-8603
Practice Address - Country:US
Practice Address - Phone:423-839-1663
Practice Address - Fax:423-839-2097
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016038183500000X
TN0000036888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist