Provider Demographics
NPI:1922329309
Name:SMALDINO, LOU MASSIMO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LOU
Middle Name:MASSIMO
Last Name:SMALDINO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SW CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3037
Mailing Address - Country:US
Mailing Address - Phone:541-389-7184
Mailing Address - Fax:541-389-7282
Practice Address - Street 1:320 SW CENTURY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3037
Practice Address - Country:US
Practice Address - Phone:541-389-7184
Practice Address - Fax:541-389-7282
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-19
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH32459183500000X
ORRPH 0013459183500000X
NV07265183500000X
WAPH 00011134183500000X
ORRPH-00134591835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist