Provider Demographics
NPI:1639765472
Name:SMITH, TRISHA LEIGH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LEIGH
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:LEIGH
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-0680
Mailing Address - Country:US
Mailing Address - Phone:501-676-2247
Mailing Address - Fax:501-676-3833
Practice Address - Street 1:115 W FRONT ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-3117
Practice Address - Country:US
Practice Address - Phone:501-676-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist