Organization Active NPI

Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1154348779
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH01770 Issued in NV
Legal business name
SMITHS FOOD & DRUG CENTERS INC
Practice address
6150 W Flamingo Rd
Las Vegas, NV 89103-2280
Phone
(702) 876-8753
Fax
(702) 873-7159
NPI assigned
Jul 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Zach Stone
Title
Pharmacy Licensing Manager
Phone
(513) 762-1019

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH01770 NV Primary

Addresses

Primary practice location

6150 W Flamingo Rd
Las Vegas, NV 89103-2280

Mailing address

PO Box 30550
Ms 44010 010C
Salt Lake City, UT 84130-0550
Phone (801) 974-1402

Other identifiers 3

IdentifierTypeStateIssuer
2051653OtherPK
002802656MedicaidNV
003302656MedicaidNV

Other names 1

  • SMITHS PHARMACY #365 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050623000861 NV Part B Supplier - Mass Immunization (Roster Biller Only) 4284674698 48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; Mesquite, NV; N Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Sparks, NV; Wendover, NV…

Other NPIs on the same Medicare enrollment 47

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 47

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6150 W Flamingo Rd
Las Vegas, NV 89103
Phone (702) 876-8753

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1154348779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30550",
            "address_2": "MS 44010 010C",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300550",
            "telephone_number": "801-974-1402",
            "fax_number": "801-973-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 W FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891032280",
            "telephone_number": "702-876-8753",
            "fax_number": "702-873-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHS FOOD & DRUG CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "ZACH",
        "authorized_official_title_or_position": "PHARMACY LICENSING MANAGER",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH01770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2051653",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002802656",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003302656",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMITHS PHARMACY #365",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.