Nicholas L Smith Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Little Chute, WI
NPI 1851724637 · NPPES record last updated Jan 7, 2026
Key facts
- NPI
- 1851724637
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 9226-42 (WI)
- Legal business name
- NICHOLAS L SMITH PHARMACY LLC
- Practice address
- 1914 Freedom Rd
Little Chute, WI 54140-1294 - Phone
- (920) 788-8888
- Fax
- (920) 788-8883
- NPI assigned
- Aug 15, 2013
- Organization subpart
- No
Authorized official
- Name
- Nicholas Lee Smith, PHARMD
- Title
- Owner / Pharmacist
- Phone
- (920) 788-8888
Subparts reporting this organization as parent 1
Corporate family (same tax ID) 1
Practitioners 1
-
Nicholas L Smith, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131106000960 | WI | Part B Supplier - Mass Immunization (Roster Biller Only) | 5799910311 | Practice locations: Little Chute, WI |
| O20161221000816 | WI | DME Supplier - Pharmacy | 5799910311 | Practice locations: Little Chute, WI |
| O20201125000479 | WI | Part B Supplier - Independent Clinical Laboratory | 5799910311 | Practice locations: Little Chute, WI |
National Provider Directory
- Tax ID family
- Nicholas L Smith Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 9226-42 | WI | Yes |
| Compounding Pharmacy | 3336C0004X | 9226-42 | WI | |
| Long Term Care Pharmacy | 3336L0003X | 9226-42 | WI |
Addresses
Primary practice location
1914 Freedom Rd
Little Chute, WI 54140-1294
Mailing address
1914 Freedom Rd
Little Chute, WI 54140-1294
Phone (920) 788-8888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10146-42 | Other | WI | STATE |
| 1851724637 | Medicaid | WI | |
| 5133905 | Other | NCPDP |
Other names
- Smith Pharmacy
Other providers in Little Chute, WI
- Timothy McMahon
- Jack R Meyer
- Gary A Miller
- Mindful Matters LLC
- Nicholas L Smith Pharmacy LLC
- NSH Little Chute LLC
- Nuwave Counseling LLC
- Optometric Services, S.C.
- Parkside Care Center LLC
- Jessica L Peterson
All providers in Little Chute, WI · Community/Retail Pharmacy in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2026. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.