Provider Demographics
NPI:1609535814
Name:SMITH, ROBERT CAREY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CAREY
Last Name:SMITH
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 1:20011 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-4931
Mailing Address - Country:US
Mailing Address - Phone:251-391-3682
Mailing Address - Fax:
Practice Address - Street 1:95 SHELL ST BLDG B
Practice Address - Street 2:
Practice Address - City:SARALAND
Practice Address - State:AL
Practice Address - Zip Code:36571-2202
Practice Address - Country:US
Practice Address - Phone:251-435-8040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11780183500000X
MSE-07910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL11780OtherALABAMA STATE BOARD OF PHARMACY
MSE-07910OtherMISSISSIPPI BOARD OF PHARMACY