Individual
MRS. STACEY K SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1787 ALLENDALE FAIRFAX HWY, FAIRFAX, SC 29827-9133
(803) 702-4279
(803) 632-8164
Mailing address
330 HAMMOND DR, ALLENDALE, SC 29810-2122
(803) 584-0823
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8721
SC LLR BOARD OF PHARMACY
SC
Enumeration date
04/08/2016
Last updated
01/20/2021
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