Smith, Derel J
Smith, Derel J is an individual health care provider with primary practice located at 12125 Highway 90 , Luling LA 70070-3000. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Smith, Derel J can be contacted via phone (985) 785-8772.Contact Information
Primary practice address
12125 Highway 90
Luling LA 70070-3000
Phone: (985) 785-8772
Fax: (985) 785-8772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | 14651 | Louisiana |
Profile Details
| NPI number | 1194829648 |
|---|---|
| LBN Legal business name | Smith, Derel J |
| Credentials | P.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194829648 | NPPES |
| Louisiana | MEDICAID | 1266884 |
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