Provider Demographics
NPI:1295857688
Name:SMITH, KAREN A (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
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 1:125 PARK PLACE CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-6690
Mailing Address - Country:US
Mailing Address - Phone:803-808-0688
Mailing Address - Fax:803-808-0698
Practice Address - Street 1:125 PARK PLACE CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-6690
Practice Address - Country:US
Practice Address - Phone:803-808-0688
Practice Address - Fax:803-808-0698
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010606183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC010606OtherPHARMACIST LICENSE