Rickey Smotherman, RPH

Key facts

NPI

1306117973

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

011737 (LA)

Practice address

2832 Front Street
Olla, LA 71465

Phone

(318) 495-5155

Fax

(318) 495-5635

NPI assigned

Jan 13, 2012

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

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.

• Smotherman Inc Community/Retail Pharmacy · Olla, LA · NPI 1851456982
  NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 13, 2012.

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1306117973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "OLLA",
            "state": "LA",
            "postal_code": "714650699",
            "telephone_number": "318-495-5155",
            "fax_number": "318-495-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 FRONT STREET",
            "city": "OLLA",
            "state": "LA",
            "postal_code": "71465",
            "telephone_number": "318-495-5155",
            "fax_number": "318-495-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOTHERMAN",
        "first_name": "RICKEY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-13",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "011737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1254045",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olla, LA

• Phillip C Rowden, M.D.
• Sahara Emergency Physicians, LLC
• Ellen Deann Shipp, LCSW
• Breanne Smith, RDN, LDN
• Smotherman Inc
• Allison Kendrick Stelly, NP
• Surgeoncare Physicians of Louisiana, LLC
• Jeffrey Tanita, M.D.
• Nuzhath Tasneem, M.D.

All providers in Olla, LA · Pharmacist in Louisiana