Provider Demographics
NPI:1851693238
Name:SMITH, EDWARD CR (RPH, MS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:CR
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 PENLAND PKWY
Mailing Address - Street 2:CARRS PHARMACY
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1928
Mailing Address - Country:US
Mailing Address - Phone:907-339-5260
Mailing Address - Fax:907-339-5219
Practice Address - Street 1:3101 PENLAND PKWY
Practice Address - Street 2:CARRS PHARMACY
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1928
Practice Address - Country:US
Practice Address - Phone:907-339-5260
Practice Address - Fax:907-339-5219
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1780183500000X
IN26014841A183500000X
TN0000033266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist