Smith Drug Co, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P00389 Issued in KY

Legal business name

SMITH DRUG CO, INC

Practice address

104 N Lincoln Blvd
Hodgenville, KY 42748

Phone

(270) 358-3306

Fax

(270) 358-8080

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Terrell Doom, PHARM.D., R.PH.

Title

Owner/Parmacist in Charge

Phone

(270) 358-3306

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1912910027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N LINCOLN BLVD",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "42748",
            "telephone_number": "270-358-3306",
            "fax_number": "270-358-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N LINCOLN BLVD",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "42748",
            "telephone_number": "270-358-3306",
            "fax_number": "270-358-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH DRUG CO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "DOOM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "OWNER/PARMACIST IN CHARGE",
        "authorized_official_telephone_number": "270-358-3306",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D., R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P00389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400547500",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ID NUMBER",
            "identifier": "1058533",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Hodgenville, KY
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.