Basic Information
| Provider Information | |||||||||
| NPI: | 1033250865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | JASON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6510 RIVERBEND DR | ||||||||
| Address2: | |||||||||
| City: | TRUSSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351731512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056551421 | ||||||||
| FaxNumber: | 2058383250 | ||||||||
| Practice Location | |||||||||
| Address1: | 50 MEDICAL PARK EAST DRIVE | ||||||||
| Address2: | PHARMACY DEPARTMENT | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352353401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058383000 | ||||||||
| FaxNumber: | 2058383250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 14246 | AL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.