Provider Demographics
NPI:1629558168
Name:SMITH MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:SMITH MANAGEMENT SERVICES, LLC
Other - Org Name:FAMILY PHARMACY #25
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEIDINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-422-3584
Mailing Address - Street 1:PO BOX 172678
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-0064
Mailing Address - Country:US
Mailing Address - Phone:864-582-1216
Mailing Address - Fax:855-971-3783
Practice Address - Street 1:916 N.W. SPRINGFIELD AVE
Practice Address - Street 2:SUITE F
Practice Address - City:AVA
Practice Address - State:MO
Practice Address - Zip Code:65608
Practice Address - Country:US
Practice Address - Phone:417-683-1760
Practice Address - Fax:417-683-1768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMITH MANAGEMENT SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-15
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy