Healthcare Provider Details

I. General information

NPI: 1346841244
Provider Name (Legal Business Name): EMILY ANNE SIMMONS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 WEST HWY 192
LONDON KY
40741
US

IV. Provider business mailing address

71 HIDDEN ACRES DR
CORBIN KY
40701-5079
US

V. Phone/Fax

Practice location:
  • Phone: 606-878-6143
  • Fax: 606-877-3041
Mailing address:
  • Phone: 606-273-4785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number018846
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: