Provider Demographics
NPI:1639456213
Name:SMITH, RALEIGH LLOYD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RALEIGH
Middle Name:LLOYD
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 1:1686 NEWMANS CARDINGTON RD E
Mailing Address - Street 2:
Mailing Address - City:WALDO
Mailing Address - State:OH
Mailing Address - Zip Code:43356-9108
Mailing Address - Country:US
Mailing Address - Phone:740-726-2214
Mailing Address - Fax:
Practice Address - Street 1:1608 MARION MOUNT GILEAD RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5822
Practice Address - Country:US
Practice Address - Phone:740-389-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-10859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist