Provider Demographics
NPI:1538407317
Name:SMITH, TIFFANY KAY (RPH)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:KAY
Last Name:SMITH
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 1:225 CARL ELLER RD
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754
Mailing Address - Country:US
Mailing Address - Phone:828-680-9463
Mailing Address - Fax:
Practice Address - Street 1:225 CARL ELLER RD
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754-0985
Practice Address - Country:US
Practice Address - Phone:828-680-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17037183500000X
SC9477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist