Provider Demographics
NPI:1336754647
Name:SMPH LLC
Entity Type:Organization
Organization Name:SMPH LLC
Other - Org Name:SPRING MILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:304-676-9878
Mailing Address - Street 1:436 FEATHERBED RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-0375
Mailing Address - Country:US
Mailing Address - Phone:304-676-9878
Mailing Address - Fax:
Practice Address - Street 1:5759 WILLIAMSPORT PIKE STE 105
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-6591
Practice Address - Country:US
Practice Address - Phone:681-242-3997
Practice Address - Fax:681-353-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy