Provider Demographics
NPI:1689646580
Name:SMITH, NORM (PHARMD PHC)
Entity type:Individual
Prefix:
First Name:NORM
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD PHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26672
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6672
Mailing Address - Country:US
Mailing Address - Phone:505-259-6548
Mailing Address - Fax:
Practice Address - Street 1:BOX 26672
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87125-6672
Practice Address - Country:US
Practice Address - Phone:505-259-6548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM44561835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy