Provider Demographics
NPI:1710018270
Name:SMILEY, TANIA (RPH)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:SMILEY
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 1:7436 CLANCY WAY
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9308
Mailing Address - Country:US
Mailing Address - Phone:614-895-0299
Mailing Address - Fax:614-895-0299
Practice Address - Street 1:200 HOFF RD
Practice Address - Street 2:SUITE A
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7153
Practice Address - Country:US
Practice Address - Phone:614-839-4654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-23851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist