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General NPI Number Information
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NPI Number | 1306107982
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Entity Type | Individual
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Provider Name | EBONY L SIMS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2012
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 1400 NORTHSIDE FORSYTH DR
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City | CUMMING
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State | GA
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Zip | 30041-7668
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Country | US
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Telephone | 404-844-3819
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Fax | 404-844-3637
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Provider Business Mailing Address
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Address Line | 1400 NORTHSIDE FORSYTH DR
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City | CUMMING
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State | GA
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Zip | 30041-7668
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Country | US
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Telephone | 404-844-3819
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Fax | 404-844-3637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RPH023052
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License Number State | GA
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