Provider Demographics
NPI:1992579122
Name:SMITH DRUG CO INC
Entity type:Organization
Organization Name:SMITH DRUG CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-354-5622
Mailing Address - Street 1:741 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4001
Mailing Address - Country:US
Mailing Address - Phone:740-354-5622
Mailing Address - Fax:740-355-2175
Practice Address - Street 1:8746 STATE ROUTE 335
Practice Address - Street 2:
Practice Address - City:MINFORD
Practice Address - State:OH
Practice Address - Zip Code:45653-8698
Practice Address - Country:US
Practice Address - Phone:740-820-2163
Practice Address - Fax:740-820-8111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMITH DRUG CO INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0316965Medicaid