Provider Demographics
NPI:1740612175
Name:SMITH, KATHERINE MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 LEWISVILLE CLEMMONS RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8716
Mailing Address - Country:US
Mailing Address - Phone:336-766-0324
Mailing Address - Fax:336-766-9810
Practice Address - Street 1:2770 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8716
Practice Address - Country:US
Practice Address - Phone:336-766-0324
Practice Address - Fax:336-766-9810
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23508183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist