Provider Demographics
NPI:1265588040
Name:SMITH, CHRISTIAN REX (RPH)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:REX
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-8622
Mailing Address - Country:US
Mailing Address - Phone:302-456-9759
Mailing Address - Fax:
Practice Address - Street 1:1416 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3905
Practice Address - Country:US
Practice Address - Phone:302-652-1994
Practice Address - Fax:302-652-6960
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001813183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist