Healthcare Provider Details

I. General information

NPI: 1164455341
Provider Name (Legal Business Name): SIMS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W COLLEGE ST
BOWDON GA
30108-1309
US

IV. Provider business mailing address

301 W COLLEGE ST
BOWDON GA
30108-1309
US

V. Phone/Fax

Practice location:
  • Phone: 770-258-3366
  • Fax: 770-258-3366
Mailing address:
  • Phone: 770-258-3366
  • Fax: 770-258-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE005917
License Number StateGA

VIII. Authorized Official

Name: KENNY ALAN AKINS
Title or Position: MANAGER
Credential:
Phone: 770-258-3366