Provider Demographics
NPI:1295102713
Name:SMITH, LUONA JANE (RPH)
Entity type:Individual
Prefix:MRS
First Name:LUONA
Middle Name:JANE
Last Name:SMITH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 PARIS PIKE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8804
Mailing Address - Country:US
Mailing Address - Phone:502-868-0599
Mailing Address - Fax:847-396-2958
Practice Address - Street 1:1501 PARIS PIKE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8804
Practice Address - Country:US
Practice Address - Phone:502-868-0599
Practice Address - Fax:847-396-2958
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009244183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist