Provider Demographics
NPI:1679584221
Name:SMITH RIKER PHARMACY INC
Entity Type:Organization
Organization Name:SMITH RIKER PHARMACY INC
Other - Org Name:A AND O SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:831-758-0976
Mailing Address - Street 1:536 ABBOTT ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4326
Mailing Address - Country:US
Mailing Address - Phone:831-769-0458
Mailing Address - Fax:831-769-0468
Practice Address - Street 1:536 ABBOTT ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4326
Practice Address - Country:US
Practice Address - Phone:831-769-0458
Practice Address - Fax:831-769-0468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY474483336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2114988OtherPK
2114988OtherPK