Organization
SMITHS FOOD & DRUG CENTERS INC
Active
Other names
SMITHS PHARMACY #188
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON MUENNICH (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
80 ACOMA BLVD N, LAKE HAVASU CITY, AZ 86403-6932
(928) 680-4449
(928) 680-6122
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y002342
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133687
—
AZ
01
—
1989391
PK
—
Enumeration date
07/13/2006
Last updated
08/31/2016
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