Basic Information
| Provider Information | |||||||||
| NPI: | 1003154006 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | SESIA | ||||||||
| MiddleName: | ROBERTS | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4605 TRENT RIVER DR | ||||||||
| Address2: | |||||||||
| City: | TRENT WOODS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285627525 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526582054 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3410 DR MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285625220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526382954 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2013 | ||||||||
| LastUpdateDate: | 01/25/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 11435 | NC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.