Basic Information
| Provider Information | |||||||||
| NPI: | 1831506906 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMMS | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 WOODSMAN CT | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282135781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043319669 | ||||||||
| FaxNumber: | 7043310736 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 WOODSMAN CT | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282135781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043319669 | ||||||||
| FaxNumber: | 7043310736 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2014 | ||||||||
| LastUpdateDate: | 07/21/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 13160 | NC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.