Provider Demographics
NPI:1639480049
Name:SMITH DRUG COMPANY
Entity Type:Organization
Organization Name:SMITH DRUG COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:870-268-6100
Mailing Address - Street 1:1104 JONES RD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-7579
Mailing Address - Country:US
Mailing Address - Phone:870-268-6100
Mailing Address - Fax:870-268-6125
Practice Address - Street 1:1104 JONES RD
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-7579
Practice Address - Country:US
Practice Address - Phone:870-268-6100
Practice Address - Fax:870-268-6125
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J.M.SMITH CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP00932302R00000X
ARR09418313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility