Individual
WHITNEY ANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 N MAIN ST, CLOVERDALE, IN 46120-8506
(765) 795-4100
Mailing address
PO BOX 357, CLOVERDALE, IN 46120-0357
(765) 795-4100
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26024501A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
351423447
FEIN
IN
Enumeration date
10/24/2017
Last updated
10/24/2017
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