Healthcare Provider Details

I. General information

NPI: 1356649891
Provider Name (Legal Business Name): ANITA SIMS PARSONS R. PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S BROAD ST
MONROE GA
30655-2106
US

IV. Provider business mailing address

1140 MALLARD CIR
BOGART GA
30622-2763
US

V. Phone/Fax

Practice location:
  • Phone: 706-752-1553
  • Fax: 770-267-2778
Mailing address:
  • Phone: 706-202-4740
  • Fax: 706-635-2246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH013355
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: