Organization
SMITH DRUG CO INC
Active
Other names
Smith Drug Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TREVOR ALAN WILLIAMS RPH (OWNER/PHARMACIST)
(662) 462-5314
Entity
Organization
Contact information
Practice address
90 MAIN ST, RIENZI, MS 38865-9144
(662) 462-5314
(662) 462-5600
Mailing address
PO BOX 138, RIENZI, MS 38865-0138
(662) 462-5314
(662) 462-5600
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00968/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00092177
—
MS
01
—
00968
STATE PHARMACY BOARD
MS
01
—
2506915
NCPDP
—
Enumeration date
08/14/2006
Last updated
09/10/2019
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