Organization
SMITHS FOOD & DRUG CENTERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (PHARMACY LICENSING MANAGER)
(513) 762-1019
Entity
Organization
Contact information
Practice address
2800 W DOVE VALLEY RD, PHOENIX, AZ 85085-5246
(480) 994-6235
(480) 994-6236
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y006935
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163977
PK
—
Enumeration date
08/30/2016
Last updated
12/04/2017
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