Provider Demographics
NPI:1275729618
Name:SMITH, RHONDA SUE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:SUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11435 OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-8144
Mailing Address - Country:US
Mailing Address - Phone:228-354-8100
Mailing Address - Fax:
Practice Address - Street 1:11435 OAKLAWN RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-8144
Practice Address - Country:US
Practice Address - Phone:228-354-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-0815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist