Provider Demographics
NPI:1184096869
Name:SMITH, CARY (PHARMD)
Entity type:Individual
Prefix:
First Name:CARY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CARY ANNE
Other - Middle Name:SMITH
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:LUMBER CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31549-0128
Mailing Address - Country:US
Mailing Address - Phone:912-375-1995
Mailing Address - Fax:
Practice Address - Street 1:8046 ROSWELL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-7023
Practice Address - Country:US
Practice Address - Phone:770-671-0657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist