Larrys Smithfield Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Smithfield, UT
NPI 1437170487 · NPPES record last updated Sep 15, 2023
Key facts
- NPI
- 1437170487
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 2774337-1703 (UT)
- Legal business name
- LARRYS SMITHFIELD PHARMACY INC
- Practice address
- 502 S Main St Ste B
Smithfield, UT 84335-2314 - Phone
- (435) 563-6262
- Fax
- (435) 563-5277
- NPI assigned
- Jul 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Larry Durrant
- Title
- Owner Pharmacist
- Phone
- (435) 563-6262
Corporate family (same tax ID) 1
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Larrys Smithfield Pharmacy Inc |
Canes and/or Crutches|Walkers|Nebulizer Equipment and/or Supplies | Does not accept assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930045358 | UT | DME Supplier - Pharmacy | 9032314232 | Practice locations: Smithfield, UT |
| O20151028001887 | UT | Part B Supplier - Pharmacy | 9032314232 | Practice locations: Smithfield, UT |
National Provider Directory
- Tax ID family
- Larrys Smithfield Pharmacy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 2774337-1703 | UT | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
502 S Main St Ste B
Smithfield, UT 84335-2314
Mailing address
502 S Main St Ste B
Smithfield, UT 84335-2314
Phone (435) 563-6262
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2100693 | Other | PK | |
| 870642231001 | Medicaid | UT |
Other names
- LARRYS SMITHFIELD PHARMACY INC
Other providers in Smithfield, UT
- Jonathan D Miles DDS, PC
- Racheal Killgore
- Schon Thomas Knowles
- Anna Marie Koopman
- Larry'S Smithfield Pharmacy, Inc.
- Lees Marketplace Inc
- Jeffrey Madsen
- Pamela Major
- Jonathan David Miles
- Trenton Morrill
All providers in Smithfield, UT · Community/Retail Pharmacy in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.