Provider Demographics
NPI:1730357906
Name:SMITH, STEVEN SCOTT (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:SCOTT
Last Name:SMITH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3168 RIVERPORT TECH CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-4825
Mailing Address - Country:US
Mailing Address - Phone:800-332-5455
Mailing Address - Fax:
Practice Address - Street 1:29 HILLSBOROUGH DR
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-6309
Practice Address - Country:US
Practice Address - Phone:618-345-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999141838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist