Provider Demographics
NPI:1639510159
Name:SMITH, HAROLD LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:LEE
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 REINE STREET
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953
Mailing Address - Country:US
Mailing Address - Phone:479-394-5144
Mailing Address - Fax:479-394-2167
Practice Address - Street 1:405 REINE ST S
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-2934
Practice Address - Country:US
Practice Address - Phone:479-394-5144
Practice Address - Fax:479-394-2167
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD05631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD05631OtherLICENSE NUMBER