NPIMap

Organization Active NPI

Smiths Food & Drug Centers Inc

Doing business as Smith's Pharmacy #304

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1780081513
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH03312 Issued in NV
Legal business name
SMITHS FOOD & DRUG CENTERS INC
Doing business as
Smith's Pharmacy #304
Practice address
4001 S Decatur Blvd
Las Vegas, NV 89103-5860
Phone
(702) 248-6510
Fax
(702) 248-3573
NPI assigned
Nov 21, 2014
Last updated
Aug 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Authorized official

Name
Allison Muennich
Title
Manager of Pharmacy Licensing
Phone
(513) 762-1019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X PH03312 NV Primary

Addresses

Primary practice location

4001 S Decatur Blvd
Las Vegas, NV 89103-5860

Mailing address

PO Box 842772
Boston, MA 02284-2772
Phone (513) 762-1019

Other identifiers 2

IdentifierTypeStateIssuer
1780081513MedicaidNV
2148975OtherPK

Other names 1

  • Smith's Pharmacy #304 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050623000861 NV Part B Supplier - Mass Immunization (Roster Biller Only) 4284674698 48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; Mesquite, NV; N Las Vegas, NV; North Las Vegas, NV; Pahrump, NV; Reno, NV; Sparks, NV; Wendover, NV…
O20150504001853 NV DME Supplier - Pharmacy 4284674698 Practice locations: Las Vegas, NV

Other NPIs on the same Medicare enrollment 47

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

View all 47

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2207028Smith's Pharmacy #3044001 S Decatur Blvd, Las Vegas, NV 89103Certificate of waiverDec 22, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Smith's Pharmacy #3044001 S Decatur Blvd, Las Vegas, NV 89103-5860(702) 248-6510 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… Accepts assignmentParticipating since Jul 7, 2025

National Provider Directory

National Provider Directory
Tax ID family
Smith's Drug Store 57274 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 23

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 23

Member of 1

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

Locations

4001 S Decatur Blvd
Las Vegas, NV 89103
Phone (702) 221-0783

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1780081513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 S DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891035860",
            "telephone_number": "702-248-6510",
            "fax_number": "702-248-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITHS FOOD & DRUG CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-21",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "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": "NV",
            "license": "PH03312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780081513",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2148975",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith's Pharmacy #304",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.