Provider Demographics
NPI:1144554452
Name:SMITHBERGER, SYLVIA T (RPH)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:T
Last Name:SMITHBERGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3298 CERRILLOS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-2925
Mailing Address - Country:US
Mailing Address - Phone:505-474-3507
Mailing Address - Fax:505-474-3394
Practice Address - Street 1:3298 CERRILLOS RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2925
Practice Address - Country:US
Practice Address - Phone:505-474-3507
Practice Address - Fax:505-474-3394
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist