Provider Demographics
NPI:1861532731
Name:SMITHERMANS PHCY
Entity type:Organization
Organization Name:SMITHERMANS PHCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHRM
Authorized Official - Phone:205-668-1801
Mailing Address - Street 1:8124 HWY 31
Mailing Address - Street 2:PO BOX 1777
Mailing Address - City:CALERA
Mailing Address - State:AL
Mailing Address - Zip Code:35040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8124 HWY 31
Practice Address - Street 2:
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040
Practice Address - Country:US
Practice Address - Phone:205-668-1801
Practice Address - Fax:205-668-1804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL108940333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0105468OtherOTHER ID NUMBER-COMMERCIAL NUMBER