Provider Demographics
NPI:1245313667
Name:SMITH, RICHARD F
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:F
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3944 STATE ROUTE 711
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-9789
Mailing Address - Country:US
Mailing Address - Phone:724-238-7344
Mailing Address - Fax:
Practice Address - Street 1:113 S FAIRFIELD ST
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1163
Practice Address - Country:US
Practice Address - Phone:724-238-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP024400L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA903297OtherMUNICIPAL POLICE