Provider Demographics
NPI:1386257301
Name:SMITH, ASHLEY MARGARET (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARGARET
Last Name: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 1:155 MOUNTAINEER DRIVE
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360
Mailing Address - Country:US
Mailing Address - Phone:570-426-1044
Mailing Address - Fax:
Practice Address - Street 1:155 POCONO CMNS
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-8703
Practice Address - Country:US
Practice Address - Phone:570-426-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP454899OtherPHARMACIST LICENSE NUMBER
PARPI014001OtherIMMUNIZATION LICENSE NUMBER