1184768889 NPI number — SMITHS FOOD & DRUG CENTERS INC

Table of content: (NPI 1184768889)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184768889 NPI number — SMITHS FOOD & DRUG CENTERS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SMITHS FOOD & DRUG CENTERS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SMITHS PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184768889
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30550
Provider Second Line Business Mailing Address:
MS44010-010C
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84130-0550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-974-1402
Provider Business Mailing Address Fax Number:
801-973-1704

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1550 S REDWOOD RD
Provider Second Line Business Practice Location Address:
MS44010-010C
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84104-5105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-974-1402
Provider Business Practice Location Address Fax Number:
801-973-1704
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARELLANO
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHARMACY, AUTHORIZED OFFICIAL DEL
Authorized Official Telephone Number:
801-974-1402

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 199 . This is a "NCPDP CHAIN CODE (RELATIONSHIP CODE)" identifier . This identifiers is of the category "OTHER".




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