Individual ProviderStephanie SmithPharmacistPharmacy Service ProvidersPractice Address11200 Montgomery Blvd NE, Albuquerque, NM 87111-2677(505) 298-7477PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1073151551Provider TypeIndividualFull NameSmith, StephanieTitleDr.CredentialRPHGenderFemaleSole ProprietorNoEnumeration Date12/16/2019Last Updated4/12/2024Contact InformationPractice LocationPractice Address11200 Montgomery Blvd NE, Albuquerque, NM 87111-2677Phone(505) 298-7477Fax(505) 299-8617Mailing LocationMailing Address11200 Montgomery Blvd NE, Albuquerque, NM 87111-2677Phone(505) 298-7477Fax(505) 299-8617Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseRP00009224New Mexico