Provider Demographics
NPI:1063761823
Name:HUNT-SMITH, JASMINE (PHARMD)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:HUNT-SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4934 ROSALIE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63115-1431
Mailing Address - Country:US
Mailing Address - Phone:314-265-8207
Mailing Address - Fax:
Practice Address - Street 1:4934 ROSALIE ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-1431
Practice Address - Country:US
Practice Address - Phone:314-265-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012025410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist