MEDICARE: SIMBA RX INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1073477899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMBA RX INC

Provider Business Mailing Address
First Line	:	265 NEW DORP LN UNIT B
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3056
Country	:	US
Telephone Number	:	929-265-3086
Fax Number	:	929-265-3081

Provider Business Practice Location Address
First Line	:	265 NEW DORP LN UNIT B
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-3056
Country	:	US
Telephone Number	:	929-265-3086
Fax Number	:	929-265-3081

Authorized Official
Title or Position	:	OWNER/SUPERVISING PHARMACIST
Name	:	DR. DON LEE
Credential	:	PHARMD
Telephone Number	:	929-500-6836

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	01/29/2026

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