Provider Demographics
NPI:1407467236
Name:SMAILI, MOHAMED (RPH)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:
Last Name:SMAILI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225R KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2361
Mailing Address - Country:US
Mailing Address - Phone:413-587-2802
Mailing Address - Fax:413-587-2808
Practice Address - Street 1:225R KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2361
Practice Address - Country:US
Practice Address - Phone:413-587-2802
Practice Address - Fax:413-587-2808
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist