Smith Drug Co Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00968/01.1 Issued in MS

Legal business name

SMITH DRUG CO INC

Doing business as

Smith Drug Co.

Practice address

90 Main St
Rienzi, MS 38865-9144

Phone

(662) 462-5314

Fax

(662) 462-5600

NPI assigned

Aug 14, 2006

Last updated

Sep 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Trevor Alan Williams, RPH

Title

Owner/Pharmacist

Phone

(662) 462-5314

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Smith Drug Co. Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1356354971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "RIENZI",
            "state": "MS",
            "postal_code": "388650138",
            "telephone_number": "662-462-5314",
            "fax_number": "662-462-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIN ST",
            "city": "RIENZI",
            "state": "MS",
            "postal_code": "388659144",
            "telephone_number": "662-462-5314",
            "fax_number": "662-462-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "662-462-5314",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00968/01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY BOARD",
            "identifier": "00968",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2506915",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00092177",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Drug Co.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smith Drug Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Rienzi, MS
• Providers in Rienzi, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.