Provider Demographics
NPI:1275833311
Name:SMITHS PHARMACY
Entity Type:Organization
Organization Name:SMITHS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:505-823-6721
Mailing Address - Street 1:8100 WYOMING BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1947
Mailing Address - Country:US
Mailing Address - Phone:505-857-9783
Mailing Address - Fax:505-857-9835
Practice Address - Street 1:8100 WYOMING BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1947
Practice Address - Country:US
Practice Address - Phone:505-857-9783
Practice Address - Fax:505-857-9835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006655183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty