Provider Demographics
NPI:1215087150
Name:SMITH, REX EARL (RPH)
Entity type:Individual
Prefix:MR
First Name:REX
Middle Name:EARL
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 COUNTY ROAD 735
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-8948
Mailing Address - Country:US
Mailing Address - Phone:256-734-1925
Mailing Address - Fax:256-734-6458
Practice Address - Street 1:209 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-1904
Practice Address - Country:US
Practice Address - Phone:256-734-6013
Practice Address - Fax:256-734-6458
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9921183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9921OtherAL BOARD OF PHARMACY NO.