Healthcare Provider Details

I. General information

NPI: 1073477899
Provider Name (Legal Business Name): SIMBA RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 NEW DORP LN UNIT B
STATEN ISLAND NY
10306-3056
US

IV. Provider business mailing address

265 NEW DORP LN UNIT B
STATEN ISLAND NY
10306-3056
US

V. Phone/Fax

Practice location:
  • Phone: 929-265-8036
  • Fax: 929-265-8031
Mailing address:
  • Phone: 929-265-8036
  • Fax: 929-265-8031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. DON LEE
Title or Position: OWNER/SUPERVISING PHARMACIST
Credential: PHARMD
Phone: 929-500-6836