Provider Demographics
NPI:1649200312
Name:SMITHFIELD PHARMACY INC
Entity Type:Organization
Organization Name:SMITHFIELD PHARMACY INC
Other - Org Name:SIMPSONS PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:757-357-4361
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23431-0384
Mailing Address - Country:US
Mailing Address - Phone:757-357-4361
Mailing Address - Fax:757-357-2626
Practice Address - Street 1:221 MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1324
Practice Address - Country:US
Practice Address - Phone:757-357-4361
Practice Address - Fax:757-357-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010007523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4809577OtherNCPDP PROVIDER IDENTIFICATION NUMBER