Jerry L Smith, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

004163 Issued in SC

Practice address

132 E Main St
Westminster, SC 29693-1753

Phone

(864) 647-5941

Fax

(864) 647-2906

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moon'S Drug Store, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Westminster, SC
  • NPI 1043236524
  NPD Authorized official
• Moon'S Drug Store, Inc.

  • Community/Retail Pharmacy
  • Westminster, SC
  • NPI 1366597270
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2023.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1023158367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 ANDERSON AVE",
            "city": "WESTMINSTER",
            "state": "SC",
            "postal_code": "296931407",
            "telephone_number": "864-647-5941",
            "fax_number": "864-647-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E MAIN ST",
            "city": "WESTMINSTER",
            "state": "SC",
            "postal_code": "296931753",
            "telephone_number": "864-647-5941",
            "fax_number": "864-647-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JERRY",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "004163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "004163",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Clark Medical Clinic Association, Inc.
• Lorie Sheriff
• Erin Lynn Sherwood
• Rhonda Small
• Ethan Smith, DC
• Joanne Smith
• Pamela Suzanne Smith, LMFT
• Sandra Smith
• Trent M Smith
• Whitney E Smith, CPHT

• All providers in Westminster, SC
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.