Provider Demographics
NPI:1306999313
Name:SMITH, ROBERT KEVIN (PHARM D, CGP, FASCP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:KEVIN
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARM D, CGP, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 WALNUT ACRES DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-7105
Mailing Address - Country:US
Mailing Address - Phone:828-994-2140
Mailing Address - Fax:828-994-2101
Practice Address - Street 1:947 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2355
Practice Address - Country:US
Practice Address - Phone:705-664-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135941835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric