Healthcare Provider Details

I. General information

NPI: 1619804580
Provider Name (Legal Business Name): ANDEEMAE SIMS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

IV. Provider business mailing address

85 ELLSWORTH RD
PEABODY MA
01960-4237
US

V. Phone/Fax

Practice location:
  • Phone: 978-354-4291
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1000817
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: