Provider Demographics
NPI:1992551329
Name:SMITH'S FOOD & DRUG CENTERS INC
Entity type:Organization
Organization Name:SMITH'S FOOD & DRUG CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING ASP
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-246-3091
Mailing Address - Street 1:1014 VINE ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1141
Mailing Address - Country:US
Mailing Address - Phone:513-246-3091
Mailing Address - Fax:513-762-1092
Practice Address - Street 1:11350 W TANGERINE RD
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653-1371
Practice Address - Country:US
Practice Address - Phone:520-635-6805
Practice Address - Fax:520-762-4530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies