Organization Active NPI

Smiths Food & Drug Centers Inc

  • Community/Retail Pharmacy
  • Goodyear, AZ
National Provider Identifier
1386686814
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y003104 Issued in AZ
Legal business name
SMITHS FOOD & DRUG CENTERS INC
Practice address
390 N Litchfield Rd
Goodyear, AZ 85338-1224
Phone
(623) 925-0233
Fax
(623) 925-2352
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Y003104 AZ Primary

Addresses

Primary practice location

390 N Litchfield Rd
Goodyear, AZ 85338-1224

Mailing address

500 S 99TH Ave
Tolleson, AZ 85353-9700
Phone (623) 907-4933

Other identifiers 2

IdentifierTypeStateIssuer
0316477OtherNCPDP PROVIDER IDENTIFICATION NUMBER
489204MedicaidAZ

Other names 1

  • FRYS FOOD AND DRUG Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050623000901 AZ Part B Supplier - Mass Immunization (Roster Biller Only) 4284674698 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Member of 1

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

Locations

390 N Litchfield Rd
Goodyear, AZ 85338
Phone (623) 925-0233

Practitioners & affiliated clinicians

Practitioners 3

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": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1386686814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 99TH AVE",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853539700",
            "telephone_number": "623-907-4933",
            "fax_number": "623-907-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N LITCHFIELD RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853381224",
            "telephone_number": "623-925-0233",
            "fax_number": "623-925-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHS FOOD & DRUG CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "PHARMACY LICENSING MANAGER",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y003104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0316477",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "489204",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRYS FOOD AND DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.