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General NPI Number Information
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NPI Number | 1689210742
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Entity Type | Individual
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Provider Name | CRAIG A SIMMONS
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Gender | Male
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 120 S MEMORIAL DR
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City | NEW CASTLE
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State | IN
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Zip | 47362-4988
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Country | US
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Telephone | 765-529-7330
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Fax | 765-521-7374
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Provider Business Mailing Address
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Address Line | 8804 CARRIAGE LN
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City | PENDLETON
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State | IN
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Zip | 46064-9340
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Country | US
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Telephone | 765-778-8452
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26017702A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 16017702A
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License Number State | IN
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