Healthcare Provider Details

I. General information

NPI: 1821398025
Provider Name (Legal Business Name): ALICIA G SIMS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7427 GOODMAN RD
OLIVE BRANCH MS
38654-1910
US

IV. Provider business mailing address

7427 GOODMAN RD
OLIVE BRANCH MS
38654-1910
US

V. Phone/Fax

Practice location:
  • Phone: 662-895-1956
  • Fax:
Mailing address:
  • Phone: 662-895-1986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-010034
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberE-010034
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24243
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: