Provider Demographics
NPI:1841418720
Name:SMITH, JANICE ANN (BS)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57032-0158
Mailing Address - Country:US
Mailing Address - Phone:605-743-2282
Mailing Address - Fax:605-743-2288
Practice Address - Street 1:220 S CLIFF AVE
Practice Address - Street 2:STE 100
Practice Address - City:HARRISBURG
Practice Address - State:SD
Practice Address - Zip Code:57032
Practice Address - Country:US
Practice Address - Phone:605-743-2282
Practice Address - Fax:605-743-2288
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist