Provider Demographics
NPI:1780965566
Name:SMITH, PATRIA S (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:PATRIA
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 W EHRINGHAUS ST # 361
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4555
Mailing Address - Country:US
Mailing Address - Phone:215-385-2430
Mailing Address - Fax:
Practice Address - Street 1:101 W EHRINGHAUS ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-4921
Practice Address - Country:US
Practice Address - Phone:252-338-3933
Practice Address - Fax:252-338-1760
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP443390183500000X
NC20347 / 0070-003451835P0018X
NC203471835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy