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Individual
LOGAN SMOLLA
Active
Individual
LOGAN SMOLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16496
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16496
PHARMACY LICENSE
NE
01
—
PHA.0025077
PHARMACY LICENSE
CO
Enumeration date
10/29/2020
Last updated
04/07/2025
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