Provider Demographics
NPI:1760881171
Name:SMITH, CHRIS (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 PRETTY MAN DR
Mailing Address - Street 2:#6107
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1142
Mailing Address - Country:US
Mailing Address - Phone:202-425-9577
Mailing Address - Fax:
Practice Address - Street 1:316 PRETTYMAN DR
Practice Address - Street 2:#6107
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4715
Practice Address - Country:US
Practice Address - Phone:202-425-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist