Provider Demographics
NPI:1801593736
Name:SMITH, ANDREW Q (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:Q
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15013 GLENDOWER DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5706
Mailing Address - Country:US
Mailing Address - Phone:502-552-0326
Mailing Address - Fax:
Practice Address - Street 1:5121 ANTLE DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-2872
Practice Address - Country:US
Practice Address - Phone:502-966-2742
Practice Address - Fax:502-966-0892
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY021481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist