Provider Demographics
NPI:1891141990
Name:SMIDI DRUGS INC
Entity Type:Organization
Organization Name:SMIDI DRUGS INC
Other - Org Name:MEMPHIS DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMIDI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:810-392-2424
Mailing Address - Street 1:80850 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:MI
Mailing Address - Zip Code:48041-4907
Mailing Address - Country:US
Mailing Address - Phone:810-392-2424
Mailing Address - Fax:810-392-3171
Practice Address - Street 1:80850 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:MI
Practice Address - Zip Code:48041-4907
Practice Address - Country:US
Practice Address - Phone:810-392-2424
Practice Address - Fax:810-392-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008418333600000X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5301008418Medicaid
MI6162370001Medicare NSC