Provider Demographics
NPI:1336167055
Name:SMITH'S DRUGS OF FOREST CITY, INC.
Entity Type:Organization
Organization Name:SMITH'S DRUGS OF FOREST CITY, INC.
Other - Org Name:SMITH'S DRUGS VITAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-245-9215
Mailing Address - Street 1:PO BOX 5047
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-5047
Mailing Address - Country:US
Mailing Address - Phone:800-447-4095
Mailing Address - Fax:601-482-7490
Practice Address - Street 1:139 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3125
Practice Address - Country:US
Practice Address - Phone:828-245-9215
Practice Address - Fax:828-245-9215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC075063336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7701783Medicaid
SCDE1708Medicaid
NC0341FOtherBCBS DME
NC6800347Medicaid
NC0394NOtherBCBS HIT
SC7N7506Medicaid
NC0815365Medicaid
SC7N7506Medicaid
0565900002Medicare NSC
NC0815365Medicaid
NC0394NOtherBCBS HIT