=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245958255
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIE SIMS PHARM. D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2022
-----------------------------------------------------
Last Update Date | 08/16/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 951 N RESLER DR
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-1452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-875-0196
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7840 KIELY RD TRLR 1
-----------------------------------------------------
City | VINTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79821-7616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-383-6792
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 70095
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------