Individual
KORENCIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 E 81ST AVE, MERRILLVILLE, IN 46410-5550
(219) 769-0013
Mailing address
4927 INDIANAPOLIS BLVD, EAST CHICAGO, IN 46312-3604
(317) 965-8638
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26020007A
IN
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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