Organization
SMITH DRUG CO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN TERRELL DOOM PHARM.D., R.PH. (OWNER/PARMACIST IN CHARGE)
(270) 358-3306
Entity
Organization
Contact information
Practice address
104 N LINCOLN BLVD, HODGENVILLE, KY 42748
(270) 358-3306
(270) 358-8080
Mailing address
104 N LINCOLN BLVD, HODGENVILLE, KY 42748
(270) 358-3306
(270) 358-8080
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P00389
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1058533
PASSPORT ID NUMBER
KY
05
—
5400547500
—
KY
Enumeration date
08/14/2006
Last updated
09/26/2013
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