NPIMap

Organization Active NPI

Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Socorro, NM
National Provider Identifier
1174548705
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH00002367 Issued in NM
Legal business name
SMITHS FOOD & DRUG CENTERS INC
Practice address
901 N California St
Socorro, NM 87801-4269
Phone
(575) 835-9495
Fax
(575) 838-4916
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Karla Langworthy
Title
Manager of Pharmacy Credentialing
Phone
(513) 698-1878

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X PH00002367 NM Primary

Addresses

Primary practice location

901 N California St
Socorro, NM 87801-4269

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2058726OtherPK
000K2066MedicaidNM

Other names 1

  • SMITHS PHARMACY #499 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000675 NM Part B Supplier - Mass Immunization (Roster Biller Only) 4284674698 23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: White Rock, NM; Albuquerque, NM; Edgewood, NM; Farmington, NM; Los Alamos, NM; Rio Rancho, NM; Santa Fe, NM; Socorro, NM…

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1174548705",
    "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": "901 N CALIFORNIA ST",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "878014269",
            "telephone_number": "575-835-9495",
            "fax_number": "575-838-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHS FOOD & DRUG CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY CREDENTIALING",
        "authorized_official_telephone_number": "513-698-1878"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NM",
            "license": "PH00002367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2058726",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000K2066",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMITHS PHARMACY #499",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Socorro, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.