Provider Demographics
NPI:1659386365
Name:SMICH, JEFFREY DANIEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DANIEL
Last Name:SMICH
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 1:10380 NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1444
Mailing Address - Country:US
Mailing Address - Phone:330-468-0132
Mailing Address - Fax:330-467-9804
Practice Address - Street 1:10380 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1444
Practice Address - Country:US
Practice Address - Phone:330-468-0132
Practice Address - Fax:330-467-9804
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2021-04-21
Deactivation Date:2020-10-13
Deactivation Code:
Reactivation Date:2021-02-25
Provider Licenses
StateLicense IDTaxonomies
OH03314460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist